Hadithi Muhammed, Cazemier Marcel, Meijer Gerrit-A, Bloemena Elisabeth, Felt-Bersma Richel-J, Mulder Chris-J, Meuwissen Stephan-Gm, Pena Amado-Salvador, van Bodegraven Adriaan-A
Department of Gastroenterology, VUmc University Medical Center, Amsterdam, PO Box 7057, Amsterdam 1007 MB, The Netherlands.
World J Gastroenterol. 2008 May 28;14(20):3183-7. doi: 10.3748/wjg.14.3183.
To describe the characteristics of Dutch patients with chronic inflammatory bowel disease (IBD) first diagnosed above 60 years of age-a disease also known as old-age colitis (OAC) and to highlight a condition that has a similar appearance to IBD, namely segmental colitis associated with diverticular disease (SCAD).
A retrospective longitudinal survey of patient demographic and clinical characteristics, disease characteristics, diagnostic methods, management and course of disease was performed. The median follow-up period was 10 years.
Of a total of 1100 IBD patients attending the Department of Gastroenterology, 59 (5%) [median age 82 years (range 64-101); 25 male (42%)] were identified. These patients were diagnosed with ulcerative colitis (n = 37, 61%), Crohn's disease (n = 14, 24%), and indeterminate colitis (n = 8, 15%). Remission was induced in 40 (68%) patients within a median interval of 6 mo (range 1-21) and immunosuppressive therapy was well tolerated. Histological evaluation based on many biopsy samples and the course of the disease led to other diagnosis, namely SCAD instead of IBD in five (8%) patients.
OAC is not an infrequent problem for the gastroenterologist, and should be considered in the evaluation of older patients with clinical features suggestive of IBD. Extra awareness and extensive biopsy sampling are required in order to avoid an erroneous diagnosis purely based on histological mimicry of changes seen in SCAD, when diagnosing IBD in the presence of diverticulosis coli.
描述60岁以上首次诊断为慢性炎症性肠病（IBD）的荷兰患者的特征——该疾病也被称为老年结肠炎（OAC），并强调一种外观与IBD相似的疾病，即与憩室病相关的节段性结肠炎（SCAD）。
对患者的人口统计学和临床特征、疾病特征、诊断方法、治疗及病程进行回顾性纵向调查。中位随访期为10年。
在总共1100例就诊于胃肠病科的IBD患者中，识别出59例（5%）[中位年龄82岁（范围64 - 101岁）；25例男性（42%）]。这些患者被诊断为溃疡性结肠炎（n = 37，61%）、克罗恩病（n = 14，24%）和不确定性结肠炎（n = 8，15%）。40例（68%）患者在中位间隔6个月（范围1 - 21个月）内实现缓解，免疫抑制治疗耐受性良好。基于多个活检样本的组织学评估和疾病病程导致5例（8%）患者被诊断为其他疾病，即SCAD而非IBD。
OAC对胃肠病学家而言并非罕见问题，在评估具有IBD临床特征的老年患者时应予以考虑。在存在结肠憩室病的情况下诊断IBD时，为避免单纯基于SCAD中所见变化的组织学模仿而做出错误诊断，需要额外的警惕性和广泛的活检取样。
