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Sequential clinical and histopathological changes in collagenous and lymphocytic colitis over time
Beth H Shaz1, Sarathchandra I Reddy, Gamze Ayata
1Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
Summary
Symptoms of collagenous colitis (CC) and lymphocytic colitis (LC) may appear before definitive histological findings are recognized. Treatment with medication showed no association with symptom or histological changes in this study.
Area of Science:
- Gastroenterology
- Pathology
- Internal Medicine
Background:
- Collagenous colitis (CC) and lymphocytic colitis (LC) are distinct histological subtypes of microscopic colitis.
- Accurate diagnosis relies on characteristic histopathological findings in colonic biopsies.
Purpose of the Study:
- To evaluate the relationship between clinical symptoms, histological features, and treatment in patients with CC and LC.
- To determine if symptoms or histological findings correlate with medication use.
Main Methods:
- Retrospective study of 19 CC and 12 LC patients with multiple colonoscopies and biopsies.
- Detailed histological review of all biopsies.
- Correlation of clinical history (symptoms, medications) with histological findings in 25 patients.
Main Results:
- Pathognomonic histological features were present to some extent in prior biopsies of 25% of CC and 50% of LC patients but were often unrecognized.
- These features were more pronounced in biopsies taken at the time of definitive diagnosis.
- No association was found between symptoms or histological findings and medication treatment.
Conclusions:
- Clinical symptoms of CC and LC may precede fully developed and recognized histological features.
- Medication use did not demonstrate a correlation with symptom or histological changes in this patient cohort.