Velasco M, Poniachik J, Chesta J, Brahm J, Latorre R, Smok G
Centro de Gastroenterología, Hospital Clínico, Universidad de Chile, Santiago.
Rev Med Chil. 1992 Aug;120(8):880-5.
Collagenous and microscopic colitis have been described as causes for abundant watery diarrhea with a normal radiologic and endoscopic aspect of the colonic mucosa. Microscopic colitis is characterized by diffuse intraepithelial lymphocytic infiltration and collagenous colitis by thickening of subepithelial collagen layer greater than 15 microns with or without inflammatory changes of the mucosa. Here are reported 5 patients with microscopic colitis and 4 with collagenous colitis. The mean age was 52 years (range 40 to 68) with an equal sex distribution. Diarrhea was of longstanding duration without weight loss, anemia or hypoalbuminemia. Occasionally the volume of diarrhea was over 1 L a day. One patient had steatorrhea that proved resistant to a gluten free diet. Endoscopic and radiologic findings were normal in every patient and the diagnosis was based on typical histology. Azulfidine therapy was successful in 7 patients and prednisone in another. Colonic biopsy should be performed in every patient with chronic diarrhea.
胶原性结肠炎和显微镜下结肠炎被认为是导致大量水样腹泻的原因,而结肠黏膜的放射学和内镜检查结果正常。显微镜下结肠炎的特征是上皮内淋巴细胞弥漫性浸润,胶原性结肠炎的特征是上皮下胶原层增厚超过15微米,伴或不伴有黏膜炎症改变。本文报告了5例显微镜下结肠炎患者和4例胶原性结肠炎患者。平均年龄为52岁(范围40至68岁),男女分布均等。腹泻持续时间长,无体重减轻、贫血或低白蛋白血症。偶尔腹泻量每天超过1升。1例患者的脂肪泻对无麸质饮食无效。每位患者的内镜和放射学检查结果均正常,诊断基于典型的组织学表现。柳氮磺胺吡啶治疗对7例患者有效,泼尼松对另一些患者有效。每位慢性腹泻患者均应进行结肠活检。