Observer variability in the histologic diagnosis of microscopic colitis

Limsui, David; Pardi, Darrell S.; Smyrk, Thomas C.; Abraham, Susan C.; Lewis, Jason T.; Sanderson, Schuyler O.; Kammer, Patricia P.; Dierkhising, Ross A.; Zinsmeister, Alan R.

doi:10.1002/ibd.20538

Cited by 42 publications

(22 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the histological criteria for MC were established in 1989, and in a previous US study, the inter-and intraobserver agreements were very reliable for the diagnostic categories of MC [14]. A recent Danish study [15] demonstrated a very good interobserver agreement when discriminating MC from normal histology, although there seems to be difficulties differentiating subgroups of MC.…”

Section: Discussionmentioning

confidence: 97%

The epidemiology of microscopic colitis: a 10-year pathology-based nationwide Danish cohort study

Bonderup

Wigh

Nielsen

et al. 2015

Scandinavian Journal of Gastroenterology

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 97%

The epidemiology of microscopic colitis: a 10-year pathology-based nationwide Danish cohort study

Bonderup

Wigh

Nielsen

et al. 2015

Scandinavian Journal of Gastroenterology

View full text Add to dashboard Cite

show abstract

“…(Fernandez-Banares et al, 1999; Fine et al, 2000; Shah et al, 2001; Olesen et al, 2004; Pardi, 2004; Limsui et al, 2009) It has been suggested that the prevalence of MC is underestimated and the true prevalence of this disease is increasing in humans. (Olesen et al, 2004; Limsui et al, 2009; Zippi et al, 2010; Yen and Pardi, 2011) The cause(s) is uncertain (Pardi et al, 2007) but it has been suggested that infectious agents or some drugs may trigger the problem. (Pardi et al, 2002; Olesen et al, 2004; Beaugerie and Pardi, 2005; Fernandez-Banares et al, 2007)…”

Section: Discussionmentioning

confidence: 99%

“…MC is a less commonly reported form of human inflammatory bowel disease (IBD). The two major forms of human IBD are lymphocytic colitis and collagenous colitis (Fernandez-Banares et al, 1999;Shah et al, 2001;Olesen et al, 2004;Pardi, 2004;Limsui et al, 2009). It has been suggested that the prevalence of MC is underestimated and the true prevalence of this disease is increasing in humans Limsui et al, 2009;Zippi et al, 2010;Yen and Pardi, 2011).…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Microscopic Colitis of Rhesus Macaques: Quantitative Assessment of Colonic Mucosa

Ardeshir

Oslund

Ventimiglia

et al. 2013

The Anatomical Record

View full text Add to dashboard Cite

Idiopathic chronic diarrhea (ICD) is a common cause of morbidity and mortality among juvenile rhesus macaques. While lesions may be absent at colonoscopy, the histopathologic evaluation of the biopsy specimens is consistent with human macroscopic colitis (MC). In this study, we developed an isotropic uniform random sampling method to evaluate macroscopic and microscopic changes and applied it on proximal ascending colon in monkeys. Colonic tissue and peripheral blood specimens were collected from six MC and six control juvenile macaques at necropsy. Uniform random samples were collected from the colon using punch biopsy tools. The volume of epithelium and lamina propria were estimated in thick (25 µm) sections using point probes and normalized to the area of muscularis mucosae. Our data suggests a significant increase of the Vs of the lamina propria (1.9 fold, p=0.02) and epithelium (1.4 fold, p=0.05) in subjects with MC. The average colonic surface mucosa area in the MC monkeys increased 1.4 fold over the controls (p=0.02). The volume of the proximal colon in animals with MC showed a 2.4 fold increase over the non-diarrhea control monkeys (p=0.0001). Cytokine, chemokine, and growth factor levels in peripheral blood were found to be correlated with the volume estimate of the lamina propria and epithelium. We found that ICD in macaques has features which simulates human MC and can be used as a spontaneous animal model for human MC. Furthermore, this developed sampling method can be used for unbiased evaluation of therapeutics in clinical trials of this animal model.

show abstract

“…Considering MC as a single group vs. colitis of other types, agreement was found to be very good ( k = 0.80–0.95). Intra‐observer agreement was also good for the 6 disease categories ( k = 0.75–0.79), and even better on differentiating MC from the rest of the biopsies ( k = 0.84–0.91) . In another study including H&E‐stained biopsies from 125 patients diagnosed with CC, LC, MCi, nonspecific colitis/IBD and normal biopsies, inter‐observer agreement among three pathologists with different degrees of experience was seen to be good ( k = 0.81–0.89) in distinguishing MC (CC, LC and MCi) from nonspecific colitis/IBD and normal biopsies.…”

Section: Statements and Recommendationsmentioning

confidence: 89%

Current concepts on microscopic colitis: evidence‐based statements and recommendations of the Spanish Microscopic Colitis Group

Fernández‐Bañares

Casanova

Arguedas

et al. 2015

Aliment Pharmacol Ther

View full text Add to dashboard Cite

Summary Background Microscopic colitis (MC) is an underdiagnosed inflammatory bowel disease. Aim To develop an evidence‐based clinical practice guide on MC current concepts. Methods Literature search was done on the Cochrane Library, EMBASE and MEDLINE electronic databases, which were consulted covering the period up until March 2015. Work groups were selected for each of the reviewed topics, with the purpose of drafting the initial statements and recommendations. They subsequently underwent a voting process based on the Delphi method. Each statement/recommendation was accompanied by the result of the vote the level of evidence, and discussion of the corresponding evidence. The grade of recommendation (GR) using the GRADE approach was established for diagnosis and treatment recommendations. Results Some key statements and recommendations are: advancing age increases the risk of developing MC, mainly in females. The symptoms of MC and IBS‐D may be similar. If MC is suspected, colonoscopy taking biopsies is mandatory. Treatment with oral budesonide is recommended to induce clinical remission in patients with MC. Oral mesalazine is not recommended in patients with collagenous colitis for the induction of clinical remission. The use of anti‐TNF‐alpha drugs (infliximab, adalimumab) is recommended for the induction of remission in severe cases of MC that fail to respond to corticosteroids or immunomodulators, as an alternative to colectomy. Conclusions This is the first consensus paper on MC based on GRADE methodology. This initiative may help physicians involved in care of these patients in taking decisions based on evidence.

show abstract

Observer variability in the histologic diagnosis of microscopic colitis

Cited by 42 publications

References 23 publications

The epidemiology of microscopic colitis: a 10-year pathology-based nationwide Danish cohort study

The epidemiology of microscopic colitis: a 10-year pathology-based nationwide Danish cohort study

Idiopathic Microscopic Colitis of Rhesus Macaques: Quantitative Assessment of Colonic Mucosa

Current concepts on microscopic colitis: evidence‐based statements and recommendations of the Spanish Microscopic Colitis Group

Contact Info

Product

Resources

About