Oruganti Poornima, Awan Rehmat, Ding Xianzhong, Wesolowski Michael, Abegunde Ayokunle T
Department of Internal Medicine, Loyola University Medical Center, Maywood, IL, United States.
Department of Pathology, Loyola University Medical Center, Maywood, IL, United States.
Front Med (Lausanne). 2021 Sep 20;8:715458. doi: 10.3389/fmed.2021.715458. eCollection 2021.
Microscopic colitis (MC) is a common cause of chronic diarrhea with limited long-term data. We searched the pathology records at our institution from 2008 to 2018 to identify cases of MC. Total sample included patients with either a diagnosis of MC or incomplete MC (MCi).Chart review was performed and data were summarized for descriptive statistics. Logistic regression was used to estimate the unadjusted effects of predictors on MC. A total of 216 patients (88.32% white, 80.56% females, mean age 67.12 +/- 15.79) were studied; 50.00% had CC, 40.28% had LC and 9.72% had MCi. Majority (52.31%) were smokers and 21.84% of females were using some form of hormonal therapy. The odds of LC in reference to CC were significantly higher for those using tricyclic antidepressants (TCAs) (OR: 3.23, 95% C.I: 1.18-8.80, = 0.02). The odds of smoking, statins, aspirin and beta-blocker use were decreased in MCi in reference to CC (all < 0.05), 29 (74.35%) patients with unresolved symptoms underwent repeat colonoscopies with biopsies. One case of MCi resolved, 8 (72.73%) out of 11 cases of LC resolved, 2 (18.18%) continued to be LC and 1 (9.09%) transformed to CC, 8 (47.06%) out of 17 cases of CC resolved, 8 (47.06%) continued to be CC and 1 (5.88%) transformed to LC. Majority of patients had CC. TCA use resulted in increased odds of LC in reference to CC. Biopsies from repeat colonoscopies in some patients revealed changes in the pathological diagnoses raising the question of interchangeability of MC (CC to LC and vice versa).
显微镜下结肠炎(MC)是慢性腹泻的常见病因,但长期数据有限。我们检索了本机构2008年至2018年的病理记录,以确定MC病例。总样本包括诊断为MC或不完全MC(MCi)的患者。进行了病历审查,并汇总数据用于描述性统计。采用逻辑回归估计预测因素对MC的未调整效应。共研究了216例患者(88.32%为白人,80.56%为女性,平均年龄67.12±15.79岁);50.00%患有胶原性结肠炎(CC),40.28%患有淋巴细胞性结肠炎(LC),9.72%患有MCi。大多数(52.31%)为吸烟者,21.84%的女性使用某种形式的激素疗法。使用三环类抗抑郁药(TCA)的患者发生LC相对于CC的几率显著更高(比值比:3.23,95%置信区间:1.18 - 8.80,P = 0.02)。与CC相比,MCi患者吸烟、使用他汀类药物、阿司匹林和β受体阻滞剂的几率降低(均P < 0.05),29例(74.35%)症状未缓解的患者接受了重复结肠镜检查及活检。1例MCi患者病情缓解,11例LC患者中有8例(72.73%)病情缓解,2例(18.18%)仍为LC,1例(9.09%)转变为CC,17例CC患者中有8例(47.06%)病情缓解,8例(47.06%)仍为CC,1例(5.88%)转变为LC。大多数患者患有CC。使用TCA导致LC相对于CC的几率增加。一些患者重复结肠镜检查的活检显示病理诊断有变化,这引发了MC(CC与LC之间相互转换)互换性的问题。