Fumery Mathurin, Kohut Mathieu, Gower-Rousseau Corinne, Duhamel Alain, Brazier Franck, Thelu Francoise, Nagorniewicz Francis, Lamarche Francois, Nguyen-Khac Eric, Sabbagh Charles, Loreau Julien, Colombel Jean-Frederic, Savoye Guillaume, Chatelain Denis, Dupas Jean-Louis
Service d'hepatogastroenterologie, Gastroenterology Unit, Amiens University and Hospital, Université de Picardie Jules Verne, Avenue Laennec-Salouel, 80000, Amiens, France.
EPIMAD registry, Amiens, France.
Dig Dis Sci. 2017 Jun;62(6):1571-1579. doi: 10.1007/s10620-016-4306-z. Epub 2016 Sep 22.
To date, there are no epidemiological data on microscopic colitis (MC) in France. The aim of this study was to determine the incidence of MC in the Somme department in Northern France, to evaluate clinical characteristics, and to search for risk factors for both collagenous colitis (CC) and lymphocytic colitis (LC).
Between January 1, 2005, and December 31, 2007, four pathology units in the Somme department recorded all new cases of MC diagnosed in patients living in the area. Colonic biopsies were reviewed by 4 pathologists together. For each incident case, demographic, clinical, endoscopic, and biological data were collected according to methodology of the EPIMAD registry.
One hundred and thirty cases of MC, including 87 CC and 43 LC, were recorded during the three-year study. The mean annual incidence for MC was 7.9/10 inhabitants, 5.3/10 inhabitants for CC, and 2.6/10 inhabitants for LC. Annual standardized incidence of Crohn's disease and ulcerative colitis in the EPIMAD registry during the same period (2005-2007) were 7.4/10 and 4.9/10, respectively. Median age at diagnosis was 63 years for MC, 70 for CC, and 48 for LC. The female-to-male gender ratio was 3.5 for MC, 4.1 for CC, and 2.6 for LC. Median time to diagnosis was 8 weeks. Chronic diarrhea and abdominal pain were, respectively, present in 93 and 47 % of the cases. An autoimmune disease was associated in 28 % of MC cases. At diagnosis, proton pump inhibitor treatment was more often reported in CC than in LC (46 vs 16 %; p = 0.003). Budesonide was effective on diarrhea in 77 % of patients, and thirteen percent of patients became steroid dependent.
This population-based study shows that the incidence of MC in France is high and similar to Crohn's disease incidence and confirms that this condition is associated with female gender, autoimmune diseases, and medications.
迄今为止，法国尚无关于显微镜下结肠炎（MC）的流行病学数据。本研究旨在确定法国北部索姆省MC的发病率，评估其临床特征，并探寻胶原性结肠炎（CC）和淋巴细胞性结肠炎（LC）的危险因素。
在2005年1月1日至2007年12月31日期间，索姆省的四个病理科记录了该地区居民中所有新诊断的MC病例。4位病理学家共同复查结肠活检样本。对于每例新发病例，按照EPIMAD登记处的方法收集人口统计学、临床、内镜及生物学数据。
在为期三年的研究中，共记录了130例MC病例，其中包括87例CC和43例LC。MC的年平均发病率为7.9/10万居民，CC为5.3/10万居民，LC为2.6/10万居民。同期（2005 - 2007年）EPIMAD登记处克罗恩病和溃疡性结肠炎的年标准化发病率分别为7.4/10万和4.9/10万。MC诊断时的中位年龄为63岁，CC为70岁，LC为48岁。MC的女性与男性性别比为3.5，CC为4.1，LC为2.6。中位诊断时间为8周。93%和47%的病例分别出现慢性腹泻和腹痛。28%的MC病例伴有自身免疫性疾病。诊断时，CC患者中质子泵抑制剂治疗的报告率高于LC（46%对16%；p = 0.003）。布地奈德对77%的患者腹泻有效，13%的患者出现激素依赖。
这项基于人群的研究表明，法国MC的发病率很高，与克罗恩病发病率相似，并证实该病与女性、自身免疫性疾病及药物有关。
