Lymphocytic colitis
{{Infobox medical condition (new)
| name = Lymphocytic colitis
| image = Lymphocytic_colitis_-_hps_-_very_high_mag.jpg
| caption = Micrograph of lymphocytic colitis. HPS stain.
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Lymphocytic colitis is a subtype of microscopic colitis, a condition characterized by chronic non-bloody watery diarrhea.{{cite journal |vauthors=Münch A, Aust D, Bohr J, Bonderup O, Fernández Bañares F, Hjortswang H, etal | title=Microscopic colitis: Current status, present and future challenges: statements of the European Microscopic Colitis Group. | journal=J Crohns Colitis | year= 2012 | volume= 6 | issue= 9 | pages= 932–45 | pmid=22704658 | doi=10.1016/j.crohns.2012.05.014 | doi-access=free }}{{cite journal| vauthors=Rasmussen MA, Munck LK| title=Systematic review: are lymphocytic colitis and collagenous colitis two subtypes of the same disease - microscopic colitis? | journal=Aliment Pharmacol Ther | year= 2012 | volume= 36 | issue= 2 | pages= 79–90 | pmid=22670660 | doi=10.1111/j.1365-2036.2012.05166.x | s2cid=24040089 | doi-access=free }}
Causes
No definite cause has been determined. The peak incidence of lymphocytic colitis is in persons over age 50; the disease affects twice as many women as men.{{Citation |last=Hempel |first=Kelby A. |title=Collagenous and Lymphocytic Colitis |date=2024 |work=StatPearls |url=https://www.ncbi.nlm.nih.gov/books/NBK541100/ |access-date=2024-09-26 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=31082144 |last2=Sharma |first2=Anuj V.|quote=There is a female preponderance in both collagenous and lymphocytic colitis. The female-to-male ratio of collagenous colitis is 3.0 and is 1.9 in lymphocytic colitis.}} Some reports have implicated long-term usage of NSAIDs, proton pump inhibitors, and selective serotonin reuptake inhibitors, and other drugs. Associations with other autoimmune disorders suggests that overactive immune responses occur.{{cite journal|last1=Park|first1=T|last2=Cave|first2=D|last3=Marshall|first3=C|title=Microscopic colitis: A review of etiology, treatment and refractory disease.|journal=World Journal of Gastroenterology|date=7 August 2015|volume=21|issue=29|pages=8804–10|doi=10.3748/wjg.v21.i29.8804|pmid=26269669|pmc=4528022|doi-access=free}}
Diagnosis
The colonoscopy is normal but histology of the mucosal biopsy reveals an accumulation of lymphocytes in the colonic epithelium and connective tissue (lamina propria). Collagenous colitis shares this feature but additionally shows a distinctive thickening of the subepithelial collagen table.
Treatment
Budesonide, in colonic release preparations, has been shown in randomized controlled trials to be effective in treating this disorder.{{cite journal|last1=Chande|first1=N|last2=Al Yatama|first2=N|last3=Bhanji|first3=T|last4=Nguyen|first4=TM|last5=McDonald|first5=JW|last6=MacDonald|first6=JK|title=Interventions for treating lymphocytic colitis.|journal=The Cochrane Database of Systematic Reviews|date=13 July 2017|volume=7|issue=11|pages=CD006096|doi=10.1002/14651858.CD006096.pub4|pmid=28702956|pmc=6483541}}{{cite journal | vauthors = Fernández-Bañares F, Salas A, Esteve M, Espinós J, Forné M, Viver J | title = Collagenous and lymphocytic colitis. evaluation of clinical and histological features, response to treatment, and long-term follow-up. | journal = Am J Gastroenterol | volume = 98 | issue = 2 | pages = 340–7 | year = 2003 | doi = 10.1111/j.1572-0241.2003.07225.x | pmid = 12591052 | s2cid = 1983209 }}
Over-the-counter antidiarrheal drugs may be effective for some people with lymphocytic colitis. Anti-inflammatory drugs, such as salicylates, mesalazine, and systemic corticosteroids may be prescribed for people who do not respond to other drug treatment. The long-term prognosis for this disease is good with a proportion of people suffering relapses which respond to treatment.
History
Lymphocytic colitis was first described in 1989.{{cite journal |vauthors=Lazenby AJ, Yardley JH, Giardiello FM, Jessurun J, Bayless TM |title=Lymphocytic ("microscopic") colitis: a comparative histopathologic study with particular reference to collagenous colitis |journal=Hum. Pathol. |volume=20 |issue=1 |pages=18–28 |year=1989 |pmid=2912870 |doi= 10.1016/0046-8177(89)90198-6}}
See also
References
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External links
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- [http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/microscopic-colitis/Pages/facts.aspx NIH ]
- [http://emedicine.medscape.com/article/180664-overview eMedicine.com]
{{Digestive system diseases}}