Atypical form of microscopic colitis in 56-year-old patient presenting with long-lasting watery diarrhea
Jacek Kiełtucki 1  
,   Joanna Zając 1  
 
More details
Hide details
1
General Internal Department and Endoscopy Unit, SPZZOZ in Staszów
CORRESPONDING AUTHOR
Jacek Kiełtucki   

Oddział Chorób Wewnętrznych i Pracownia Endoskopii, SPZZOZ w Staszowie, ul. 11 listopada 78, 28-200 Staszów
 
Ann. Acad. Med. Siles. 2019;73:114–118
 
KEYWORDS
TOPICS
ABSTRACT
Microscopic colitis (MC) is a common cause of unexplainable, chronic diarrhea. The disease is characterized by the presence of clinical symptoms, a normal colonoscopy and typical histopathological changes upon microscopic examination. The aim of the study was to present a case of an atypical histological form of MC. A 56-year-old man presented with chronic, watery diarrhea. Gastrointestinal infection had been excluded. The colon appeared almost normal on the colonoscopy. Inconsistent histological findings were observed. The pathology of randomly taken colon biopsies showed collagenous colitis (CC; thickness of collagen bands > 10 µm, < 20 IELs). Six months later during a follow-up colonoscopy, colonic specimens revealed typical findings of lymphocytic colitis (LC), namely, no thickened subepithelial collagen bands were identified. The authors analyzed the risk factors, diagnosis, treatment response, clinical course and the atypical histological outcomes.
CONFLICT OF INTEREST
The authors declare no conflict of interest.
FUNDING
This publication was created as part of the Regional Programme National Cohesion Strategy: The project “Creation of unique endosonography unit ‒ EUS, in Świętokrzyskie voivodeship in order to begin perfor- ming research”, co-financed by the European Union from the European Regional Development Fund under the Regional Operational Programme of the Święto- krzyskie voivodeship for the years 2007–2013.
 
REFERENCES (14)
1.
Carpenter H.A., Tremaine W.J., Batts K.P., Czaja A.J. Sequential histologic evaluations in collagenous colitis. Correlations with disease behavior and sampling strategy. Dig. Dis. Sci. 1992; 37(12): 1903–1909.
 
2.
Andrews C.N., Beck P.L., Wilsack L., Urbanski S.J., Storr M. Evaluation of endoscopist and pathologist factors affecting the incidence of microscopic colitis. Can. J. Gastroenterol. 2012; 26(8): 515–520.
 
3.
Goff J.S., Barnett J.L., Pelke T., Appelman H.D. Collagenous colitis: histopathology and clinical course. Am. J. Gastroenterol. 1997; 92(1): 57–60.
 
4.
Guagnozzi D., Landolfi S., Vicario M. Towards a new paradigm of microscopic colitis: incomplete and variant forms. World J. Gastroenterol. 2016; 22(38): 8459–8471.
 
5.
Nguyen G.C., Smalley W.E., Vege S.S., Carrasco-Labra A. American Gastroenterological Association Institute Guideline on the Medical Management of Microscopic Colitis. Gastroenterology 2016; 150(1): 242–246, doi: 10.1053/j.gastro.2015.11.008.
 
6.
Pardi D.S., Kelly C.P. Microscopic colitis. Gastroenterology 2011; 140(4): 1155–1165, doi: 10.1053/j.gastro.2011.02.003.
 
7.
Münch A., Langner C. Microscopic colitis: Clinical and Pathologic Perspectives. Clin. Gastroenterol. Hepatol. 2015; 13(2): 228–236, doi: 10.1016/j. cgh.2013.12.026.
 
8.
Gentile N., Yen E.F. Prevalence, Pathogenesis, Diagnosis, and Management of Microscopic Colitis. Gut Liver 2018; 12(3): 227–235, doi: 10.5009/gnl17061.
 
9.
Münch A., Aust D., Bohr J., Bonderup O., Fernández Bañares F., Hjortswang H., Madisch A., Munck L.K., Ström M., Tysk C., Miehlke S. Microscopic colitis: Current status, present and future challenges: statements of the European Microscopic Colitis Group. J. Crohns Colitis 2012; 6(9): 932–945.
 
10.
Mellander M.R. Microscopic colitis. Thesis for doctoral degree. Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden. 2017, p. 6–31.
 
11.
Cotter T.G., Kamboj A.K., Hicks S.B., Tremaine W.J., Loftus E.V., Pardi D.S. Immune modulator therapy for microscopic colitis in a case series of 73 patients. Aliment. Pharmacol. Ther. 2017; 46(2): 169–174, doi: 10.1111/ apt.14133.
 
12.
Storr M.A. Microscopic Colitis: Epidemiology, Pathophysiology, Diagnosis and Current Management – An Update 2013. ISRN Gastroenterol. 2013; 2013: 352718, doi: 10.1155/2013/352718.
 
13.
Marques S., Carmo J., Bispo M. An Unusual Cause of Chronic Diarrhea. Gastroenterology 2016; 150(2): 326–327, doi: 10.1053/j.gastro.2015.11.044.
 
14.
Menon R., Ng C. Sertraline-induced microscopic colitis. Psychosomatics 2015; 56(3): 316–317, doi: 10.1016/j.psym.2014.03.008.
 
eISSN:1734-025X