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Inflammatory bowel disease
Published in Michael JG Farthing, Anne B Ballinger, Drug Therapy for Gastrointestinal and Liver Diseases, 2019
Elizabeth Carty, Anne B Ballinger
There are two main types of microscopic colitis: Lymphocytic colitis (which is characterized by a subepithelial lymphocytic infiltrate in the colonic mucosa); andCollagenous colitis (which is characterized by a thickened subepithelial collagen band).
Stomach and duodenum
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
This type of gastritis is seen rarely. It is characterised by the infiltration of the gastric mucosa by T cells and is probably associated with H. pylori infection. The pattern of inflammation resembles that seen in coeliac disease or lymphocytic colitis.
Other disease associations: Liver, gastrointestinal, respiratory, and neoplastic
Published in M. Alan Menter, Caitriona Ryan, Psoriasis, 2017
The term “microscopic colitis” was initially coined in the 1980s to describe a noninfectious chronic diarrheal disease characterized by histological changes in the presence of endoscopically normal or near normal mucosa. It is an inflammatory condition of the colon of unknown etiology and currently includes two histologically distinct entities, termed lymphocytic colitis and collagenous colitis. The disease is presented clinically with watery diarrhea, crampy abdominal pain, nausea, and weight loss, and, as mentioned, it requires histological demonstration of specific abnormalities of the endothelial colonic mucosa for its diagnosis. As opposed to what is seen in IBD, extraintestinal manifestations are rare in microscopic colitis.34,35
Microscopic colitis and its associations with complications observed in classic inflammatory bowel disease: a systematic review
Published in Scandinavian Journal of Gastroenterology, 2020
Microscopic colitis (MC) is a less known disease in the group inflammatory bowel disease (IBD) that is characterized by chronic non-bloody diarrhea, occasionally associated with involuntary weight loss and abdominal cramps [1–3]. MC has an incidence rate of approximately 10/100,000 per year, with a predilection for women and for those ≥60 years of age [1,2]. Both collagenous and lymphocytic colitis have an increased number of intraepithelial lymphocytes, a decreased amount of goblet cells and surface changes which consists of loosely attached cuboidal epithelia. Additionally, in collagenous colitis (CC), the subepithelial collagen layer is thickened (>10 µm) [4]. There is evidence supporting that patients with CC are considered to have a longer and more symptomatic course of their disease than patients with lymphocytic colitis (LC) [5]. The pathophysiology of MC is not completely understood. There is however an association between MC and a certain human leukocyte antigen (HLA) haplotype, namely HLA-DQ2, which is also known to be associated with other autoimmune diseases such as celiac disease, thyroid diseases and type 1 diabetes [6,7].
Endoscopical and pathological dissociation in severe colitis induced by immune-checkpoint inhibitors
Published in OncoImmunology, 2020
Carlos Eduardo de Andrea, Jose Luis Perez-Gracia, Eduardo Castanon, Mariano Ponz-Sarvise, Jose I. Echeveste, Ignacio Melero, Miguel F. Sanmamed, Maria Esperanza Rodriguez-Ruiz
In the CT-SCAN performed 19 weeks after treatment onset, the patient showed a partial response (80% decrease) by RECIST 1.1 criteria, and she remained on treatment. Following cycle 10 (29 weeks), she presented grade-2 colitis due to grade-3 diarrhea (seven non-bloody stools per day over baseline), abdominal pain and a total weight loss of 4 kg during the diarrhea (31 weeks). Nivolumab was interrupted and infectious colitis was ruled out after bacteriological, virological and parasitological analyses of stools, including testing for Clostridium difficile toxin. Upper digestive tract endoscopy did not show any endoscopic abnormalities. However, a colonoscopy showed macroscopically normal-appearing mucosa in the whole length of the colon (Figure 1a and b). Interestingly, severe lymphocytic colitis was observed in multiple colonic biopsies. Hematoxylin-eosin staining and immunohistochemical staining showed an increased intraepithelial infiltration of CD8+ lymphocytes (>10/100 enterocytes) with a severe CD4+ and CD8+ lymphocytic infiltration in the lamina propria (Figure 1c–e).
Vasoactive intestinal peptide-oma causing refractory diarrhea in a young woman
Published in Baylor University Medical Center Proceedings, 2020
Nagasri Shankar, Catherine Linzay, Kyle Rowe
A 36-year-old white woman presented to the hospital with recurrent episodes of persistent diarrhea and dehydration of 2 years duration. Her diarrhea was watery and voluminous, exceeded 2 to 3 L per day, and persisted despite fasting. There was an associated 30-pound weight loss and mild, generalized abdominal pain. The diarrhea was refractory to multiple therapies including loperamide, colestipol, tincture of opium, and elimination diets. Colonoscopy with biopsy demonstrated increased intraepithelial lymphocytes suggestive of lymphocytic colitis. Trials of budesonide and cholestyramine were attempted but unsuccessful. A cholecystectomy was also performed.