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Microscopic, Lymphocytic and Collagenous Colitis
November 15, 2013 7:00 am
Microscopic Colitis (MC) is a rare pediatric problems and occurs when chronic diarrhea occurs in the presence of a normal-appearing endoscopic exam but with abnormal histology. In adult populations, microscopic colitis is seen more frequently and can be confused with irritable bowel syndrome. The two subtypes:
- Lymphocytic Colitis (LC): >20 intraepithelial lymphocytes/100 colonocytes
- Collagenous Colitis (CC): thickened subeptihelial collagen band in addition to changes seen with LC
In a recent study (JPGN 2013; 57: 557-61), 27 MC cases were identified from a pathology database between 1995-2011. 5 were excluded due to an enteric infection. Among the 22 other cases, 19 had LC and 3 had CC. Association with celiac disease was evident in 4 patients and many had preceding drug exposures.
Treatment included steroids, melamine, an bismuth.
Additional references:
- -JPGN 2011; 53: 579. lymphocytic colitis case report
- -Clincal Gastro & Hep 2011; 9: 13. Celaic with persistent symptoms: consider poor adherence**, SBBO*, pancreatic insufficiency*, refractory celiac (rare), PLE, giardia, malignancy, lactose intolerance, functional d/o*, microscopic colitis, Crohn’s*, NSAIDs
- -Gut 2009; 58: 68-72. Collagenous colitis: Budesonide at 6mg/day maintained remission in ~25%.
- Gastro 2008; 135: 1510. Budesonide effective for collagenous colitis; n=48, 9mg/day.
- -Gastro 2011; 140: 1155. Review of microscopic colitis/collagenous colitis.
- -Am J Gastroenterol 2010; 105: 859-865. n=466 & 451 controls. Microscopic colitis present in 1.5% of IBS patients. IBS pts with lower incidence of adenomas (7.7.% vs 26%). 9% had diverticulosis (lower).
- -Clin Gastro & hep 2009; 7: 1210. 4.3% of pts w microscopic colitis had celiac. 44/1009.
Posted by gutsandgrowth
Categories: Pediatric Gastroenterology Intestinal Disorder
Tags: budesonide, celiac, collagenous colitis, diarrhea, irritable bowel syndrome, lymphocytic colitis, microscopic colitis
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