Simultaneous Occurrence of Collagenous Colitis and Crohn’s Disease

Chandratre, S; Bramble, M G; Cooke, W M; Jones, R.

doi:10.1159/000199399

Cited by 55 publications

(19 citation statements)

References 9 publications

(15 reference statements)

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“…Three of the patients in our register had Crohn's disease diagnosed before the diagnosis of collagenous colitis. Two earlier reports have described the development of Crohn's disease before or after collagenous colitis.26 27 The association between the two diseases might be coincidental.…”

Section: Discussionmentioning

confidence: 97%

Collagenous colitis: a retrospective study of clinical presentation and treatment in 163 patients.

Bohr

Tysk

Eriksson

et al. 1996

Gut

349

380

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Background-Data on collagenous colitis have been based on a limited number of patients. Aims-To obtain more information on this disease from a register set up at Orebro Medical Center Hospital. Patients and methods-Twenty five Swedish hospitals have contributed to this patient register, which comprises 163 histopathologically verified cases. Clinical data were retrospectively analysed. Results-Collagenous colitis followed a chronic intermittent course in most cases (85%) with a sudden onset in 42%. Symptoms were chronic watery diarrhoea, often nocturnal (27%), abdominal pain (41%), and weight loss (42%). Sixty six patients (40%) had one or more associated diseases. Routine laboratory data were mostly normal. The median age at diagnosis was 55 (range 16-86) years, but 25% of the patients were younger than 45 years. Seven patients died of unrelated diseases. The response rate for sulphasalazine was 59%, and 50% and 40% for mesalazine and olsalazine. Prednisolone was most effective with a response rate of 82%/ but the required dose was often high and the effect was not sustained after withdrawal. Antibiotics were efficient in 63%. Cholestyramine and loperamide had response rates of 59% and 71% respectively. Conclusions-Collagenous colitis follows a chronic continuous course. Symptoms can be socially disabling, but the disease does not seem to have a malignant potential. A plan for the treatment of a newly diagnosed patient with coliagenous colitis is proposed.

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Section: Discussionmentioning

confidence: 97%

Collagenous colitis: a retrospective study of clinical presentation and treatment in 163 patients.

Bohr

Tysk

Eriksson

et al. 1996

Gut

349

380

View full text Add to dashboard Cite

show abstract

“…Neutrophilic cryptitis and crypt abscesses may be present occasionally but are unusual. If significant cryptitis is present, other possibilities should be considered, including acute colitis, mild forms of chronic crypt-destructive colitis, or two coexisting diseases (104). Brainerd diarrhea is an epidemic diarrhea with the combined histological features of lymphocytic colitis and acute colitis of infectious origin (105).…”

Section: Ajg -April 2000mentioning

confidence: 99%

The importance of clinicopathological correlation in the diagnosis of inflammatory conditions of the colon: histological patterns with clinical implications

Carpenter

Talley

2000

Am J Gastroenterology

108

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Histological reaction patterns within the colon are not disease-specific but reflect mechanisms of injury and duration of disease. By correlating these patterns with known causes of colonic inflammation, we provide guidelines to enhance the diagnostic value of colonoscopic samples. Normal histological features are reviewed, and the sequence of inflammation and repair is used as the basis for appreciating pathological deviations. The common histological patterns of acute colitis with and without features of pseudomembranous or ischemic colitis and the morphological features of chronic colitis with and without crypt destruction are collated with clinical and endoscopic features to emphasize the importance of dialogue between the pathologist and gastroenterologist. Less common patterns, including eosinophilic colitis, graft-versus-host disease, chronic mucosal prolapse, portal hypertensive colopathy, and nonspecific or idiopathic ulcer, illustrate variations in the basic reaction patterns. Difficulties in differential diagnosis are underscored, and biopsy strategies are suggested.

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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%

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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Simultaneous Occurrence of Collagenous Colitis and Crohn’s Disease

Abstract: A 59-year-old woman who presented initially with clinical and histological features of collagenous colitis subsequently developed Crohn’s disease of the small and large bowel.

Cited by 55 publications

References 9 publications

Collagenous colitis: a retrospective study of clinical presentation and treatment in 163 patients.

Collagenous colitis: a retrospective study of clinical presentation and treatment in 163 patients.

The importance of clinicopathological correlation in the diagnosis of inflammatory conditions of the colon: histological patterns with clinical implications

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

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