Development and Validation of a Scoring System to Identify Patients With Microscopic Colitis

Abstract

Grant support:None. Abbreviations

Irritable Bowel Syndrome and Microscopic Colitis: A Systematic Review and Meta-analysis

“…derived and validated a novel diagnostic scoring system to distinguish patients with MC from those with functional bowel disease on the basis of clinical data. 22 This scoring system had a sensitivity of 90.5% and a specificity of 45.3% when the optimal cut-off of ≥8 was used. The authors concluded that applying the diagnostic scoring system would obviate the need for random colonic biopsies in 37%-49% of patients without MC, and reduce the total costs associated with excluding MC in this group of patients.…”

“…Collagenous colitis (CC) differs from lymphocytic colitis (LC) in that it presents a sub-epithelial collagen band adjacent to the basal membrane, whereas the hallmark of LC is a dense lymphocytic infiltration in the epithelium. The condition is commoner in women, 22 is a frequent cause of an altered bowel habit towards looser stools, 23,24 and is often accompanied by abdominal pain. [25][26][27] The incidence of MC has been reported as 2.6 to 21.0 Kamp et al…”

Diagnostic Algorithm and Treatment for Microscopic Colitis: A Review.

“…From present literature it has to be assumed that there is an emerging need to identify a non-invasive diagnostic tool that can predict the presence of active MC and distinguish MC from other functional and organic causes of watery diarrhea (Cotter et al 2016) (Pisani et al 2017) (Macaigne et al 2014). Such a diagnostic tool would furthermore serve to better assess the real need for colonoscopy and histological evaluation (Pisani et al 2017) (Macaigne et al 2014) (Kane et al 2015). As a matter of fact, this non-invasive test should be rapid, inexpensive, standardized, reproducible, and accurate in reflecting the predominant lymphocytic activity in the large bowel of patients suffering from MC (Pisani et al 2017).…”

“…The differential diagnosis of MC is very large and mainly includes infectious colitis, resolving acute infectious colitis, post-dysenteric IBS, drug-induced changes, particularly those related to the intake of non-steroidal inflammatory drugs, but the classic IBD and celiac disease also have to be ruled out ) (Guagnozzi et al 2016)(Jauregui-Amezaga, Vermeire, and Geboes 2016). Usually colonoscopy cannot be avoided in patients with chronic diarrhea, but the ability to identify a subset of patients at higher risk of MC has the potential to reduce the number of patients in whom biopsies are taken and recent scoring systems have been proposed to identify lower risk patients (Cotter et al 2016) (Kane et al 2015). Series of clinical studies have shown that those patients with MC are more than 50 years of age, report weight loss, have a duration of diarrhea < 12 months, have recently taken a new drug, and have a coexisting autoimmune disease(s) (Macaigne et al 2014) (Cotter et al 2016) (Kane et al 2015).…”

“…Usually colonoscopy cannot be avoided in patients with chronic diarrhea, but the ability to identify a subset of patients at higher risk of MC has the potential to reduce the number of patients in whom biopsies are taken and recent scoring systems have been proposed to identify lower risk patients (Cotter et al 2016) (Kane et al 2015). Series of clinical studies have shown that those patients with MC are more than 50 years of age, report weight loss, have a duration of diarrhea < 12 months, have recently taken a new drug, and have a coexisting autoimmune disease(s) (Macaigne et al 2014) (Cotter et al 2016) (Kane et al 2015). From present literature it has to be assumed that there is an emerging need to identify a non-invasive diagnostic tool that can predict the presence of active MC and distinguish MC from other functional and organic causes of watery diarrhea (Cotter et al 2016) (Pisani et al 2017) (Macaigne et al 2014).…”