| Lymphocytic colitis | |
|---|---|
 | |
| Micrograph of lymphocytic colitis. HPS stain. | |
| Specialty |
Gastroenterology
 |
Lymphocytic colitis is a subtype of microscopic colitis, a condition characterized by chronic non-bloody watery diarrhea. [1] [2]
Causes
No definite cause has been determined. The peak incidence of lymphocytic colitis is in persons over age 50; the disease affects women and men equally. 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. [3]
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. [1] [2]
Treatment
Budesonide, in colonic release preparations, has been shown in randomized controlled trials to be effective in treating this disorder. [4] [5]
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. [1]
History
Lymphocytic colitis was first described in 1989. [6]
See also
References
- ^ a b c Münch A, Aust D, Bohr J, Bonderup O, Fernández Bañares F, Hjortswang H, et al. (2012). "Microscopic colitis: Current status, present and future challenges: statements of the European Microscopic Colitis Group". J Crohns Colitis. 6 (9): 932–45. doi: 10.1016/j.crohns.2012.05.014. PMID 22704658.
- ^ a b Rasmussen MA, Munck LK (2012). "Systematic review: are lymphocytic colitis and collagenous colitis two subtypes of the same disease - microscopic colitis?". Aliment Pharmacol Ther. 36 (2): 79–90. doi: 10.1111/j.1365-2036.2012.05166.x. PMID 22670660. S2CID 24040089.
- ^ Park, T; Cave, D; Marshall, C (7 August 2015). "Microscopic colitis: A review of etiology, treatment and refractory disease". World Journal of Gastroenterology. 21 (29): 8804–10. doi: 10.3748/wjg.v21.i29.8804. PMC 4528022. PMID 26269669.
- ^ Chande, N; Al Yatama, N; Bhanji, T; Nguyen, TM; McDonald, JW; MacDonald, JK (13 July 2017). "Interventions for treating lymphocytic colitis". The Cochrane Database of Systematic Reviews. 7 (11): CD006096. doi: 10.1002/14651858.CD006096.pub4. PMC 6483541. PMID 28702956.
- ^ Fernández-Bañares F, Salas A, Esteve M, Espinós J, Forné M, Viver J (2003). "Collagenous and lymphocytic colitis. evaluation of clinical and histological features, response to treatment, and long-term follow-up". Am J Gastroenterol. 98 (2): 340–7. doi: 10.1111/j.1572-0241.2003.07225.x. PMID 12591052. S2CID 1983209.
- ^ Lazenby AJ, Yardley JH, Giardiello FM, Jessurun J, Bayless TM (1989). "Lymphocytic ("microscopic") colitis: a comparative histopathologic study with particular reference to collagenous colitis". Hum. Pathol. 20 (1): 18–28. doi: 10.1016/0046-8177(89)90198-6. PMID 2912870.