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Microscopic colitis with granuloma which responded to steroid therapy
Hiroki Iwai1, Tadakazu Hisamatsu, Hideko Iizuka
1Department of Internal Medicine, School of Medicine, Keio University, Tokyo.
Internal Medicine (Tokyo, Japan)
|September 20, 2007
Summary
A patient with chronic watery diarrhea and weight loss was diagnosed with granulomatous colitis, not typical microscopic colitis. Treatment with prednisolone led to remission, highlighting a novel therapeutic approach for this rare condition.
Area of Science:
- Gastroenterology
- Pathology
- Internal Medicine
Background:
- Microscopic colitis presents with chronic watery diarrhea but typically lacks granulomas on biopsy.
- Distinguishing between various colitis subtypes is crucial for effective patient management.
Observation:
- A 67-year-old female presented with chronic watery diarrhea, weight loss, hypoalbuminemia, and elevated immunoglobulin G and C-reactive protein.
- Colonoscopy revealed normal gross findings, but histopathology showed non-necrotizing granulomas and multinucleated giant cells.
Findings:
- Histopathological examination revealed granulomatous inflammation, differentiating the case from lymphocytic or collagenous colitis.
- The patient's symptoms and laboratory abnormalities significantly improved following treatment with prednisolone.
Implications:
- This case suggests granulomatous colitis can mimic microscopic colitis, necessitating thorough histopathological review.
- Successful short-term steroid treatment indicates a potential therapeutic strategy for this rare condition.
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