Collagenous, microscopic and lymphocytic colitis. An evolving concept

Bogomoletz, W. V.

doi:10.1007/bf00195769

Cited by 60 publications

(18 citation statements)

References 43 publications

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“…The distribution and amount of surface IELs was too focal and mild to be categorized histologically as lymphocytic colitis. [2][3][4][5]7,8 Nevertheless, the features of the most heavily inflamed areas of these NSAID-associated colitis biopsies and those of lymphocytic colitis overlapped. NSAIDs have been linked to collagenous colitis.…”

Section: Discussionmentioning

confidence: 99%

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The Histopathology of Nonsteroidal Anti-inflammatory Drug-Associated Colitis

Goldstein

Cinenza

1998

Am J Clin Pathol

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Section: Discussionmentioning

confidence: 99%

“…Although not measured, a normal subsurface collagen layer thickness was defined as less than the thickened subsurface collagen band of collagenous colitis. [3][4][5][6][7][8][9] 9. Pericryptal fibroblastic sheath thickness, categorized as either normal or thickened.…”

Section: Methodsmentioning

confidence: 99%

The Histopathology of Nonsteroidal Anti-inflammatory Drug-Associated Colitis

Goldstein

Cinenza

1998

Am J Clin Pathol

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“…The histologic findings of intraepithelial lymphocytic infiltrates and epithelial injury throughout the gastric and intestinal biopsy material and the serologic presence of several autoantibodies, including antigliadin, antiendomysial, and pANCA, are unifying features. Recently, reports have shown overlap of both related and seemingly (17,(21)(22)(23)(24)(25). Associated clinical and pathologic features of these chronic inflammatory bowel diseases suggest overlapping causes or a similar pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

“…All control cases were age-matched, and those classified as gastritis included seven cases that originally were diagnosed as chronic nonspecific gastritis, one case of chronic atrophic gastritis with intestinal metaplasia, and two cases of active chronic gastritis with Helicobacter pylori. Studies of the colon have indicated a collagen table thickness with an upper range of 3 to 7 as normal (17,18).…”

Section: Methodsmentioning

confidence: 99%

Collagenous Gastritis: A Case Report, Morphologic Evaluation, and Review

et al. 2000

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Collagenous gastritis is rare; there are only four previous case reports. Histologic features seem to overlap with the other "collagenous enterocolitides"; however, pathologic criteria are not yet established for the diagnosis of collagenous gastritis. We describe an additional case of ostensible collagenous gastritis in a patient who initially presented with celiac sprue and subsequently developed colonic manifestations of mucosal ulcerative colitis. Endoscopic biopsies of the stomach revealed deposition of patchy, very thick bandlike subepithelial collagen in gastric antral mucosa, focal superficial epithelial degeneration, numerous intraepithelial lymphocytes, and a dense lamina propria lymphoplasmacytic infiltrate. Image analysis evaluation of gastric antral biopsies demonstrated a mean thickness of subepithelial collagen of 27.07 . Morphologic comparison was made with age-matched control groups of 10 patients who had normal gastric mucosal biopsies and 10 patients who had "chronic" gastritis, which revealed mean subepithelial collagen measures of 1.37 and 1.19 , respectively. We compared these morphologic findings with those of all previous case reports of collagenous gastritis and propose a pathologic definition based on the limited combined data. It seems that subepithelial collagen is dramatically thickened in reported cases of collagenous gastritis, with a cumulative mean measure of 36.9 . ⌱t is also apparent from this and previous reports that the thickened subepithelial collagen is accompanied by a chronic or chronic active gastritis and sometimes intraepithelial lymphocytes and surface epithelial damage. Recently described associations of lymphocytic gastritis, sprue, and lymphocytic colitis as well as collagenous and lymphocytic colitis suggest a common pathogenesis that empirically may include collagenous gastritis in the same disease spectrum. We propose that collagenous gastritis can be confidently identified by using analogous defined features of collagenous colitis: subepithelial collagen more than 10 in a patchy distribution, lamina propria lymphoplasmacytic infiltrates, intraepithelial lymphocytes, and surface epithelial damage. Collagenous gastritis also seems to have the same spectrum of associated clinical findings as collagenous colitis, including frequent coexistence of celiac sprue, watery diarrhea syndrome, and female predominance.

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“…First described in 1976 [9], and for a long time considered to be very rare, it has now become clear this is one of the main causes of chronic watery diarrhea in patients without or with unspecific (such as erythema and mucosal edema) endoscopic findings [5, 6, 10, 11, 12, 13, 14, 15]. Currently, the term microscopic colitis is used for all those conditions characterized by chronic watery diarrhea, with normal radiological and endoscopic appearances in the presence of microscopic changes [11, 16, 17, 18]. The term microscopic colitis includes the diagnoses collagenous colitis, lymphocytic colitis and eosinophilic colitis [16].…”

Section: Introductionmentioning

confidence: 99%

Colonoscopy and SeHCAT for Investigation of Chronic Diarrhea

Müller¹,

Wïllén

Stotzer³

2004

Digestion

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Background/Aims: Chronic diarrhea is a common problem. Colonoscopy is the investigation of choice for diagnosis. Even a macroscopically normal mucosa on endoscopy can have abnormalities such as microscopic colitis and bile acid malabsorption (BAM). The aim of this study was to establish the value of colonoscopy with biopsies in patients with chronic diarrhea and to evaluate the additive value of a SeHCAT test for diagnosing BAM in these patients. Methods: All patients who underwent a colonoscopy between November 1999 and December 2000 were included. Patient files, colonoscopy and pathology reports and SeHCAT test results were reviewed. Results: 205 patients were included. The most common diagnoses were diarrhea-predominant IBS (n = 76) and IBD (n = 38). 158 patients had non-bloody diarrhea, 113 (72%) of them had a macroscopically normal appearing mucosa. In 40 (35%) of these patients, a histological diagnosis could be made and microscopic colitis was the most common diagnosis (n = 27). SeHCAT test was performed in 36 patients and 15 (42%) of them had BAM. In the 47 patients with bloody diarrhea, IBD was the main diagnosis (n = 23). Conclusion: Colonoscopy with biopsies must be performed when investigating chronic diarrhea and BAM should be excluded.

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Collagenous, microscopic and lymphocytic colitis. An evolving concept

Cited by 60 publications

References 43 publications

The Histopathology of Nonsteroidal Anti-inflammatory Drug-Associated Colitis

The Histopathology of Nonsteroidal Anti-inflammatory Drug-Associated Colitis

Collagenous Gastritis: A Case Report, Morphologic Evaluation, and Review

Colonoscopy and SeHCAT for Investigation of Chronic Diarrhea

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