medigraphic.com
Colegio de Medicina Interna de México.

2024, Number 01

<< Back Next >>

Med Int Mex 2024; 40 (01)

Diagnosis of microscopic colitis

Arias RLF, Torres BO, González TA, Martínez VE, Quiñonez ÁMF, Ávila TA

Language: Spanish
References: 23
Page: 12-18
PDF size: 247.62 Kb.


ABSTRACT

Objective: To determine the endoscopic sensitivity for each segment of the colon.
Materials and Methods: Observational and retrospective study performed in the Laboratory of Histopathology and Molecular Biology of the Hospital Ángeles del Carmen, Guadalajara, Jalisco, Mexico, with the histopathological tests practiced from January 2018 to October 2021 in patients with colorectal biopsies, stained with hematoxylin and eosin and simultaneously analyzed by four specialists in pathological anatomy by light microscopy. For statistical analysis of the data, Statgraphics 18 software was used to determine the sensitivity of histopathologic examination of each colonic segment.
Resultados: Histopathologic studies of colorectal biopsies from 130 patients diagnosed with microscopic colitis were reviewed. By segment alone, the sigmoid colon had the highest sensitivity, followed by the ascending colon and the descending colon. Collagenous colitis was more common in men than in women; mixed lymphocytic and microscopic colitis were more common in women. The mean ages for collagenous colitis, lymphocytic colitis, and mixed microscopic colitis were 50.7 ± 21.8, 50.44 ± 17.6, and 49.2 ± 23.3 years, respectively.
Conclusions: Due to the high frequency of mixed microscopic colitis, it is important to consider it a subtype of microscopic colitis in future studies. Contrary to previous reports, the results of this study show that collagenous colitis is more common in men than in women.


REFERENCES

  1. Miehlke S, Verhaegh B, Tontini GE, Medisch A, et al. Microscopiccolitis: pathophysiology and clinical management.Lancet Gastroenterol Hepatol 2019; 4: 305-14. https://doi.org/10.1016/S2468-1253(19)30048-2

  2. Macaigne G, Lahmek P, Locher C, Boivin JF, et al. Over90% of cases of microscopic colitis can be diagnosed byperforming a short colonoscopy. Clin Res Hepatol Gastroenterol2017; 41: 333-40. https://doi.org/10.1016/j.clinre.2016.12.008

  3. Fiehn AMK, Heiberg Engel PJ, Lanzarotto F, Goudkade D, etal. Topographical distribution of microscopic colitis and theimportance of orientation of paraffin embedded biopsies.Hum Pathol 2020; 103: 63-71. https://doi.org/10.1016/j.humpath.2020.07.011.

  4. Abd El-Fattah Badran MA, Rozik MS, Hammam OA, MohamedMD. Prevalence of microscopic colitis in patientsfulfilling Rome IV criteria of irritable bowel syndromediarrheal type. Al-Azhar Med J 2021; 50: 707-18. https://doi.org/10.21608/amj.2021.139865.

  5. Miehlke S, Guagnozzi D, Zabana Y, Tontine GE, et al. Europeanguidelines on microscopic colitis: United EuropeanGastroenterology (UEG) and European Microscopic ColitisGroup (EMCG) statements and recommendations. UEG J2020; 1: 1-28. https://doi.org/10.1177/2050640620951905.

  6. Prieto Ortíz RG, Prieto Ortíz JE. Colitis microscópica: undiagnóstico en aumento. Rev Colomb Gastroenterol 2019;34 (4): 399-403. https://doi.org/10.22516/25007440.377.

  7. Veress B, Löfberg R, Bergman L. Microscopic colitis syndrome.Gut 1995; 36: 880-86. https://doi.org/10.1136/gut.36.6.880.

  8. Fiehn AK, Miehlke S, Aust D, Vieth M, et al. Distribution ofhistopathological features along the colon in microscopiccolitis. Int J Colorectal Dis 2021; 36: 151-59. https://doi.org/10.1007/s00384-020-03747-z.

  9. Burke KE, D’Amato M, Ng SC, Pardi DS, et al. Microscopiccolitis. Nat Rev Dis Primers 2021; 7: 39. https://doi.org/10.1038/s41572-021-00273-2.

  10. Sandler RS, Keku TO, Woosley JT, Galanko JA, et al. Medicationuse and microscopic colitis. Aliment Pharmacol Ther2021; 54: 1193-201. https://doi.org/10.1111/apt.16594.

  11. Wildt S, Munck LK, Winther-Jensen M, Jess T, et al. Autoimmunediseases in microscopic colitis: A Danish nationwidecase-control study. Aliment Pharmacol Ther 2021; 54:1454-62. https://doi.org/10.1111/apt.16614.

  12. Fernández-Bañares F, Esteve M, Farré C, Salas A, et al.Predisposing HLA-DQ2 and HLA-DQ8 haplotypes of coeliacdisease and associated enteropathy in microscopic colitis.Eur J Gastroenterol Hepatol 2005; 17: 1333-38. https://doi.org/10.1097/00042737-200512000-00011.

  13. Krogsgaard LR, Munck LK, Bytzer P, Wildt S. An alteredcomposition of the microbiome is microscopic colitis isdriven towards the compositions in healthy controls bytreatment with budesonide. Scand J Gastroenterol 2019;54: 446-52. doi: 10.1080/00365521.2019.1599064.

  14. Langner C, Aust D, Ensari A, Villanacci V, et al. Histologyof microscopic colitis-review with a practical approach forpathologists. Histopathology 2015; 66: 613-26. https://doi.org/10.1111/his.12592.

  15. Lazenby AJ, Yardley JH, Giardiello FM, Jessurun J, etal. Lymphocytic (‘microscopic’) colitis: a comparativehistopathologic study with particular reference to collagenouscolitis. Hum Pathol 1989; 20: 18-28. https://doi.org/10.1016/0046-8177(89)90198-6.

  16. Baert F, Wouters K, D’Haens G, Hoang P, et al. Lymphocyticcolitis: a distinct clinical entity? A clinicopathologicalconfrontation of lymphocytic and collagenous colitis. Gut1999; 45: 375-81. https://doi.org/10.1136/gut.45.3.375.

  17. Rasmussen MA, Munck LK. Systematic review: are lymphocyticcolitis and collagenous colitis two subtypes ofthe same disease - microscopic colitis? Aliment PharmacolTher 2012; 36: 79-90. https://doi.org/10.1111/j.1365-2036.2012.05166.x.

  18. Brown WR, Tayal S. Microscopic colitis. A review. J DigDis 2013; 14: 277-281. https://doi.org/10.1111/1751-2980.12046.

  19. Fernández‐Bañares F, Casanova MJ, Arguedas Y, Beltrán B,et al. Current concepts on microscopic colitis: evidencebasedstatements and recommendations of the SpanishMicroscopic Colitis Group. Aliment Pharmacol Ther 2016;43: 400-26. https://doi.org/10.1111/apt.13477.

  20. Tagkalidis P, Bhathal P, Gibson P. Microscopic colitis. JGastroenterol Hepatol 2002; 17: 236-48. https://doi.org/10.1046/j.1440-1746.2002.02640.x.

  21. Kamboj AK, McGoldrick J, Voth E, Penrice D, et al. Clinicalcharacteristics and treatment response in microscopiccolitis based on age at diagnosis: A multicenter retrospectivestudy. Dig Dis Sci 2021. https://doi.org/10.1007/s10620-021-07162-4.

  22. Mihaly E, Patai Á, Tulassay Z. Controversials of microscopiccolitis. Front Med (Lausanne) 2021; 8: 717438. https://doi.org/10.3389/fmed.2021.717438.

  23. Virine B, Chande N, Driman DK. Biopsies from ascendingand descending colon are sufficient for diagnosis of microscopiccolitis. Clin Gastroenterol Hepat 2020; 18: 2003-9.DOI:https://doi.org/10.1016/j.cgh.2020.02.036.




2020     |     www.medigraphic.com