Increased Colonic Intraepithelial Lymphocytes in Patients With Hashimoto's Thyroiditis

Cındoruk, Mehmet; Tuncer, Candan; Dursun, Ayşe; Yetkin, İlhan; Karakan, Tarkan; Çakır, Nuri; Soykan, İrfan

doi:10.1097/00004836-200203000-00008

Cited by 42 publications

(27 citation statements)

References 9 publications

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“…Recently, 40% of patients with Hashimoto's thyroiditis were reported to show histologic findings of lymphocytic colitis, another disorder closely linked to collagenous colitis and celiac disease. 27 This report extends this relationship of autoimmune thyroid disease to collagenous colitis even if celiac disease is not present.…”

Section: Discussionsupporting

confidence: 72%

Collagenous Colitis as the Presenting Feature of Biopsy-Defined Celiac Disease

Freeman¹

2004

Journal of Clinical Gastroenterology

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Section: Discussionsupporting

confidence: 72%

Collagenous Colitis as the Presenting Feature of Biopsy-Defined Celiac Disease

Freeman¹

2004

Journal of Clinical Gastroenterology

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“…It must be present along with the increased inflammatory component of the lamina propria and in the right clinical setting, because there are other situations in which lymphocytic colitis-like histology has been described, including drugs such as ticlopidine, Brainerd diarrhea (an infectious colitis), other immune diseases such as Hashimoto's thyroiditis, and in some patients with inconsistent gastrointestinal symptoms like hematochezia or constipation. [35][36][37][38] In addition, patients with Crohn disease have been reported to have patches of lymphocytic colitis-like histology. 39 The lymphocytosis in either microscopic colitis is frequently patchy, so that not all of the biopsies from a patient will have the diagnostic features.…”

Section: Discussionmentioning

confidence: 99%

Is It Really Colitis?

McKenna¹

2004

Pathology Case Reviews

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Histologically normal or near-normal colonic biopsies from patients with diarrhea make up a significant proportion of routine gastrointestinal biopsy cases. Recognizing and reporting these biopsies as normal is important, because it facilitates diagnosis and management of patients presumed to have irritable bowel syndrome. There are a number of trivial and/or iatrogenic deviations from normal found in colorectal biopsies. These must be separated from true disease or inaccurate, meaningless, or even harmful biopsy reports could be issued. The differential diagnosis for patients with chronic diarrhea includes the microscopic colitides. Although the typical features of lymphocytic and collagenous colitis are familiar to most pathologists, some cases of microscopic colitis have atypical features that could obscure the correct diagnosis.A 42-year-old woman reported recurring episodes of abdominal pain and nonbloody diarrhea for the past year, recently increasing in frequency. Full colonoscopy was performed. At colonoscopy, a few aphthous-like lesions were seen; colonoscopy was otherwise normal. Biopsies of the right and left colon, to include aphthoid lesions, were performed.

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“…Co-occurrence of various other autoimmune diseases has been reported, including thyroid diseases in up to 20% of patients, diabetes in 10% and rheumatoid arthritis in 2.5% [14,18,19,20,21]. Concomitant autoimmune disorders may be more common in CC patients than in LC patients [22].…”

Section: Etiology and Pathogenesismentioning

confidence: 99%

Microscopic Colitis

Bouma¹,

Münch²

2015

Dig Dis

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Microscopic colitis (MC) is the common denominator for lymphocytic and collagenous colitis (CC). It is now recognized as a relatively frequent cause of diarrhea that equals the prevalence of inflammatory bowel disease. Patients are typically middle-aged women, but disease may occur at every age. Patients with MC report watery, non-bloody diarrhea in the absence of endoscopic and radiologic abnormalities. Lymphocytic colitis is characterized by an increased number of intraepithelial lymphocytes, and CC by a thickened subepithelial collagen band, whereas in both an increased mononuclear infiltration of the lamina propria is found. The pathogenesis of MC is largely unknown, but may relate to autoimmunity, adverse reactions to drugs or (bacterial) toxins, and abnormal collagen metabolism in the case of CC. Budesonide is so far the only drug that has proven efficacy in randomized controlled trials both for the induction and maintenance of remission. Patients who are nonresponsive, dependent or who experience side effects on budesonide may benefit from thiopurine or anti-TNF treatment, but these options are still experimental. The long-term prognosis of MC is good; it does not appear to predispose to malignancies and can in some cases be self-limiting. Further research and randomized clinical trials are required to expand our understanding of the natural course and the pathogenesis of MC.

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Increased Colonic Intraepithelial Lymphocytes in Patients With Hashimoto's Thyroiditis

Cited by 42 publications

References 9 publications

Collagenous Colitis as the Presenting Feature of Biopsy-Defined Celiac Disease

Collagenous Colitis as the Presenting Feature of Biopsy-Defined Celiac Disease

Is It Really Colitis?

Microscopic Colitis

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