Over 90% of cases of Microscopic Colitis can be diagnosed by performing a short colonoscopy - 15/12/17
, Pierre Lahmek b, Christophe Locher c, Jean François Boivin a, Bruno Lesgourgues d, Mathieu Yver c, Laurent Costes e, I. Abd Alsamad e, Joel Cucherousset d, Claire Charpignon f, Hélène Guyot f, Bénédicte Lambaré g, Jean-Michel Ghilain h, Valérie Calès i, Stéphanie de Montigny-Lenhardt j, Guy Bellaïche k, Alexandre Pariente i, 1, Stéphane Nahon d, 1for the
COLMI Group of the Association Nationale des Gastroentérologues des Hôpitaux (ANGH)2
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| Vidéos | 0 |
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Summary |
Aims |
To determinate the topographical distribution of key diagnostic histological features of lymphocytic colitis (LC) and collagenous colitis (CC) and to establish what correlations may exist between the histological findings and the causes and severity of MC.
Patients and methods |
Patients with MC were included in a prospective multicentre French study from September 2010 to October 2012. MC was diagnosed by performing total colonoscopy with multiple biopsies of the rectum and colon collected in separate jars and analyzed separately for each site (descending and sigmoid colon, transverse colon, ascending colon). CC was defined as a subepithelial collagen layer>10μm thick and LC as an intraepithelial lymphocyte (IEL) count>20 lymphocytes per 100 epithelial cells without any associated thickening of the subepithelial collagen.
Results |
Ninety-five patients, 69 with LC 26 and with CC, were included in the analysis. The sensitivity of the biopsies for diagnosing MC was maximum in the transverse colon and minimum in the rectum. Rectal and left colonic biopsies resulted in the diagnosis of CC and CL in 93% and 94% of cases, respectively. All the remaining cases of MC were diagnosed by performing additional biopsies beyond the splenic flexure. In patients with LC, a higher rate of IELs was associated with the absence of abdominal pain (P=0.01) and a shorter duration of diarrhea (P=0.001). In patients with CC, a lower level of collagen thickness in the basement membrane was associated with the presence of an autoimmune disease (P=0.02).
Conclusion |
More than 90% of cases of microscopic colitis were diagnosed in this study by performing rectal and left colonic biopsies.
Le texte complet de cet article est disponible en PDF.Abbreviations : CC, H. pylori, IELs, LC, MC
Plan
Vol 41 - N° 3
P. 333-340 - juin 2017 Retour au numéro
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