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Microscopic colitis: Is it a spectrum of inflammatory bowel disease?

World Journal of Gastroenterology 2013年第26期19卷 4252-4256页

作者： Ramprasad Jegadeesan Xiuli Liu Mangesh R Pagadala Norma Gutierrez mujtaba butt Udayakumar Navaneethan Department of Gastroenterology and Hepatology Digestive Disease Institute Department of Pathology Pathology and Laboratory Medicine Institute Cleveland Clinic

Lymphocytic and collagenous colitis are forms of microscopic colitis which typically presents in elderly patients as chronic watery diarrhea. The association between microscopic colitis and inflammatory bowel disease is weak and unclear. Lymphocytic colitis progressing to ulcerative colitis has been previously reported; however there is limited data on ulcerative colitis evolving into microscopic (lymphocytic or collagenous) colitis. We report a series of six patients with documented ulcerative colitis who subsequently were diagnosed with collagenous colitis or lymphocytic colitis suggesting microscopic colitis could be a part of the spectrum of inflammatory bowel disease. The median duration of ulcerative colitis prior to being diagnosed with microscopic colitis was 15 years. We noted complete histological and/or symptomatic remission in three out of six cases while the other three patients reverted back into ulcerative colitis suggesting lymphocytic or collagenous colitis could present as a continuum of ulcerative colitis. The exact molecular mechanism of this histological transformation or the prognostic implications is still unclear. Till then it might be prudent to follow up these patients to assess for the relapse of inflammatory bowel disease as well as for dysplasia surveillance.

关键词： Ulcerative colitis Lymphocytic colitis Microscopic colitis Collagenous colitis Inflammatory bowel disease

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