组织病理学
显微镜下结肠炎
医学
炎症性肠病
淋巴细胞性结肠炎
内科学
胃肠病学
结肠炎
组织学
置信区间
人口
基于人群的研究
胶原性结肠炎
病理
流行病学
疾病
环境卫生
作者
Amnon Sonnenberg,Robert M. Genta
出处
期刊:Journal of Crohn's and Colitis
[Oxford University Press]
日期:2022-03-17
卷期号:16 (9): 1415-1419
被引量:6
标识
DOI:10.1093/ecco-jcc/jjac046
摘要
In a subgroup of patients with microscopic colitis [MC], its histopathology changed from lymphocytic [LC] to collagenous colitis [CC] and vice versa. Previous studies have also observed histopathological transitions between MC and inflammatory bowel disease [IBD].The aim of the present study was to analyse the prevalence of such transitions in a large population of MC patients.The Inform Diagnostics database is an electronic repository of histopathology records of patients distributed throughout the USA. In a cross-sectional study, we analysed the prevalence of changes in MC histology. Each prevalence was expressed as the rate per 100 MC patients with its 95% Poisson confidence interval.In a total population of 29 307 MC patients, our cross-sectional study focused on a subgroup of 4363 patients who underwent two or more consecutive colonoscopies between December 2008 and March 2020. Overall, 1.6% [95% CI 1.2-2.0%] of patients changed their MC phenotype from LC to CC, and 0.5% [0.3-0.7%] from CC to LC. Of 4363 MC patients, 414 [9.5%] were also diagnosed with IBD. In 2.9% [2.4-3.5%], MC and IBD were diagnosed as synchronous mucosal lesions. In 2.1% [1.7-2.6%], MC changed to IBD, and in 4.5% [3.9-5.2%] IBD changed to MC.The analysis confirmed the synchronous occurrence of MC and IBD and transitions between the two diagnoses. In patients who fail therapy for either one of the two diseases, the gastroenterologist should search for changes in the underlying phenotype as a possible explanation.
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