AIM: To evaluate the potential association between mild duodenal damage and microscopic colitis (MC). METHODS: We retrospectively included 105 consecutive patients with type I Marsh-Oberhuber duodenal damage and negativity for immunoglobulin A anti-endomysium and anti-tissue transglutaminase. The following parameters were analyzed: Sex, age at execution of esophagogastroduodenoscopy, duodenal damage, and number of intraepithelial lymphocytes at biopsies, prevalence of Helicobacter pylori infection, age at execution of colonoscopy, macroscopic and microscopic features of colonoscopy, family history of gastrointestinal and autoimmune diseases, smoking habits, biochemical parameters of inflammation and autoimmunity, use of proton pump inhibitors or nonsteroidal anti-inflammatory drugs, adverse reactions to drugs or foods, pathologies known to be associated with celiac disease or MC, living on a gluten-free diet or on a gluten-low diet for at least 1 mo. RESULTS: Colonoscopy was performed in 59 patients, but only in 48 of them biopsies were taken in the entire colon. Considering the latter cohort, the diagnosis of MC was met in 25 (52.1%) patients while in 18 patients other pathologic findings were reported: 13 (27%) cases of nonspecific inflammatory bowel disease, 2 (4.2%) cases of Crohn's disease, 2 (4.2%) cases of eosinophilic gastroenteritis, and 1 (2.1%) case of autoimmune enteritis. Five (10.4%) patients had a normal colonoscopic result. Matching the groups by age, and considering only patients who underwent colonoscopy (42.7 ± 15.5 years) vs those who did not undergo colonoscopy (36.9 ± 10.6 years), a statistical difference was found (P = 0.039). Focusing on symptoms, diarrhea was statistically more prevalent in MC group than in patients who did not undergo colonoscopy (P = 0.03). CONCLUSION: Mild duodenal damage is associated with MC in more than half of the cases. This association supports the hypothesis of a link between these two entities.

Microscopic colitis in patients with mild duodenal damage: A new clinical and pathological entity ("lymphocytic enterocolitis")?

RIBALDONE, Davide Giuseppe;FAGOONEE, SHARMILA;SAPONE, Nicoletta;CAVIGLIA, GIAN PAOLO;SARACCO, Giorgio Maria;PELLICANO, Rinaldo
2016

Abstract

AIM: To evaluate the potential association between mild duodenal damage and microscopic colitis (MC). METHODS: We retrospectively included 105 consecutive patients with type I Marsh-Oberhuber duodenal damage and negativity for immunoglobulin A anti-endomysium and anti-tissue transglutaminase. The following parameters were analyzed: Sex, age at execution of esophagogastroduodenoscopy, duodenal damage, and number of intraepithelial lymphocytes at biopsies, prevalence of Helicobacter pylori infection, age at execution of colonoscopy, macroscopic and microscopic features of colonoscopy, family history of gastrointestinal and autoimmune diseases, smoking habits, biochemical parameters of inflammation and autoimmunity, use of proton pump inhibitors or nonsteroidal anti-inflammatory drugs, adverse reactions to drugs or foods, pathologies known to be associated with celiac disease or MC, living on a gluten-free diet or on a gluten-low diet for at least 1 mo. RESULTS: Colonoscopy was performed in 59 patients, but only in 48 of them biopsies were taken in the entire colon. Considering the latter cohort, the diagnosis of MC was met in 25 (52.1%) patients while in 18 patients other pathologic findings were reported: 13 (27%) cases of nonspecific inflammatory bowel disease, 2 (4.2%) cases of Crohn's disease, 2 (4.2%) cases of eosinophilic gastroenteritis, and 1 (2.1%) case of autoimmune enteritis. Five (10.4%) patients had a normal colonoscopic result. Matching the groups by age, and considering only patients who underwent colonoscopy (42.7 ± 15.5 years) vs those who did not undergo colonoscopy (36.9 ± 10.6 years), a statistical difference was found (P = 0.039). Focusing on symptoms, diarrhea was statistically more prevalent in MC group than in patients who did not undergo colonoscopy (P = 0.03). CONCLUSION: Mild duodenal damage is associated with MC in more than half of the cases. This association supports the hypothesis of a link between these two entities.
7
4
307
313
Autoimmune diseases; Celiac disease; Helicobacter pylori; Intraepithelial lymphocytes; Lymphocytic colitis; Lymphocytic enterocolitis; Microscopic colitis
Bonagura, Gabriele Antonio; Ribaldone, Davide Giuseppe; Fagoonee, Sharmila; Sapone, Nicoletta; Caviglia, Gian Paolo; Saracco, Giorgio Maria; Astegiano, Marco; Pellicano, Rinaldo
File in questo prodotto:
File Dimensione Formato  
WJGP-7-307.pdf

Accesso aperto

Tipo di file: PDF EDITORIALE
Dimensione 939.8 kB
Formato Adobe PDF
939.8 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2318/1620880
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact