Significance of basement membrane thickening in the human colon.

Abstract

SUMMARY Collagenous colitis is a rare condition characterised by watery diarrhoea. It is thought to be caused by a thick collagenous membrane found immediately beneath the colonic surface epithelium. We have studied specimens from 457 patients with a wide variety of large bowel diseases in order to determine the frequency, nature, and clinical correlations of the thick membranes. The normal membrane measured up to 3 microns. In 19 (4%) of the patients studied there was significant thickening (greater than 10 A). In 12 patients the thickening ranged from 10-15 ,u, and six of this group had diarrhoea. In seven, the membrane exceeded 15 ,u, and six patients had diarrhoea. There was no correlation between the nature of the disease process, bleeding, pain, constipation or previous medication. It did not vary with the age, nor at different sites of the colon. We concluded that no case in this series represented an example of true collagenous colitis but that significant thickening of the membrane occurs in other disease conditions and that a thick membrane, no matter how it arises, is causally associated with profuse watery diarrhoea.

Subepithelial basement membrane thickness in patients with normal colonic mucosal appearance in colonoscopy: Results from southern Turkey

“…The main histopathological criteria for collagenous colitis include the characteristic findings of a thick, continuous, hypocellular, eosinophilic, linear fibrous band beneath the surface epithelium, as well as intraepithelial lymphocytosis, epithelial vacuolization, and desquamation [1,3,[5][6][7]11] . One of the difficulties in diagnosing collagenous colitis is that different sources cite different SEBM thickness as one of the main criteria for diagnosis [9] .…”

“…Lindstrom introduced the term "collagenous colitis" to describe a colon biopsy that showed hyalinized substance, known as a collagen band, between the transition zone of the subluminal basement membrane and the lamina propria [1][2][3][4][5][6][7][8] . The English literature contains approximately 200 reports of this condition [7] .…”

“…The English literature contains approximately 200 reports of this condition [7] . Collagenous colitis is most often diagnosed in middle-aged women [3,[6][7][8][9][10] . In some patients this condition is associated with autoimmune diseases, such as diabetes mellitus, primary biliary cirrhosis, rheumatoid arthritis, and glutensensitive enteropathy [3] .…”

“…In some patients this condition is associated with autoimmune diseases, such as diabetes mellitus, primary biliary cirrhosis, rheumatoid arthritis, and glutensensitive enteropathy [3] . Some of the cases linked with histories of smoking, or antibiotic or non-steroidal anti-inflammatory drug (NSAID) ingestion [1,3,6,7,9,11] . In healthy adults, the subepithelial basement membrane (SEBM) of the colon consists of collagen types I and IV, laminin, and fibronectin.…”

“…In healthy adults, the subepithelial basement membrane (SEBM) of the colon consists of collagen types I and IV, laminin, and fibronectin. The thickness of this layer varies from 0 to 7 µm [3,[5][6][7]12] , and is slightly greater in the settings of hyperplastic polyps, colonic diverticulum, and congenital megacolon [3,6] . In this study, we investigated SEBM thickness in biopsies from five different colonic sites in patients from the southern Anatolia region of Turkey.…”