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Related Experiment Videos

Indeterminate colitis.

M Guindi1, R H Riddell

  • 1Department of Laboratory Medicine and Pathobiology, University of Toronto, and Department of Pathology, University Health Network, Toronto, Ontario, Canada, M5G 2C4. maha.guindi@uhn.on.ca

Journal of Clinical Pathology
|November 26, 2004
PubMed
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Indeterminate colitis (IC) is challenging to diagnose, often evolving to ulcerative colitis (UC) or Crohn's disease (CD) over time. This review examines diagnostic methods and proposes a clinicopathological approach for inflammatory bowel disease (IBD).

Area of Science:

  • Gastroenterology
  • Pathology
  • Internal Medicine

Background:

  • Indeterminate colitis (IC) represents a diagnostic challenge in inflammatory bowel disease (IBD), historically defined by difficulties distinguishing ulcerative colitis (UC) and Crohn's disease (CD) in colectomy specimens.
  • The definition of IC has broadened to include cases where definitive UC or CD diagnosis is not possible via colonoscopy, biopsies, or colectomy, leading to variable prevalence reporting.

Purpose of the Study:

  • To review the role of ancillary tests in differentiating UC from CD.
  • To propose a clinicopathological approach for diagnosing IC, moving beyond purely histological definitions.

Main Methods:

  • Review of ancillary diagnostic tests for distinguishing UC from CD.
  • Analysis of clinical, endoscopic, and imaging findings.

Related Experiment Videos

  • Discussion of serological markers, upper endoscopy, and magnetic resonance imaging (MRI) utility.

    • Main Results:

    • Most patients initially diagnosed with IC eventually develop a definitive diagnosis of UC or CD upon follow-up.
    • Low sensitivity of current serological markers limits their diagnostic value in differentiating UC and CD.
    • A clinicopathological definition, integrating clinical and pathological findings, is suggested over a purely histological one.

    Conclusions:

    • Indeterminate colitis diagnosis requires a comprehensive clinicopathological assessment.
    • Further research into sensitive and specific diagnostic markers for early IBD differentiation is warranted.
    • An integrated approach considering clinical evolution and ancillary tests is crucial for managing IC.