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Microscopic colitis: a new cause of chronic diarrhea in children?
M N Mashako1, E Sonsino, J Navarro
1Service de Gastro-entérologie et Nutrition Pédiatrique, Hôpital Robert Debre, Paris, France.
Insights
Microscopic colitis in children, though rare, can cause chronic diarrhea. This study found that symptomatic treatment led to remission in all five pediatric patients, suggesting it
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Pathology
Background:
- Microscopic colitis is a condition characterized by chronic watery diarrhea.
- It is typically diagnosed in adults, with limited data on pediatric cases.
Purpose of the Study:
- To investigate the clinical presentation and outcomes of microscopic colitis in children.
- To assess the efficacy of symptomatic treatment for pediatric microscopic colitis.
Main Methods:
- Retrospective review of five pediatric patients with normal endoscopic findings but microscopic colitis on biopsies.
- Analysis of clinical symptoms, treatment regimens, and follow-up outcomes.
Main Results:
- Patients presented with chronic diarrhea (mean 14 months), vomiting, abdominal pain, anorexia, distension, and weight loss.
- Symptomatic treatments (loperamide, trimebutine, aluminum/magnesium silicate) and one case of sulfasalazine were used.
- All patients achieved normal stools after one year, with normal follow-up biopsies in most cases.
Conclusions:
- Microscopic colitis should be considered in the differential diagnosis of chronic diarrhea in children.
- Symptomatic management appears effective in achieving remission in pediatric cases.
Abstract:
From a retrospective study on children who underwent colonoscopy or rectosigmoidoscopy with multiple level biopsies, we selected five patients whose rectocolonic endoscopic aspect was normal and contrasting with the presence of a microscopic colitis on biopsies. These five children had chronic diarrhea (mean duration of 14 months), associated with vomiting (three cases), abdominal pain (two cases), anorexia (two cases), abdominal distension (two cases), and weight loss (four cases). Symptomatic treatment was used in all children: loperamide (one case), trimebutine (three cases), and aluminium and magnesium silicate (two cases). One child received sulfasalazine for 2 months. After 1 year, all patients had normal stools. Rectosigmoidoscopy was performed in four patients and was normal. Biopsies obtained in three cases were normal in two cases and showed a persistent microscopic colitis in one case. Microscopic colitis may be a distinct cause of chronic diarrhea in children.