Division of Pediatric Gastroenterology, Hepatology and Nutrition, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Paediatr Drugs. 2022 May;24(3):217-233. doi: 10.1007/s40272-022-00504-3. Epub 2022 May 2.
Microscopic colitis (MC) is an inflammatory disease of the colon, characterized by chronic watery diarrhea with distinguishing histologic findings despite normal endoscopic appearance of the colonic mucosa. MC is a common cause of diarrhea in older adults, though it has been infrequently reported in children and adolescents. As MC is rare in the pediatric population, and the clinical presentation is non-specific, increased awareness of this disease amongst pediatric clinicians and pathologists is essential for timely diagnosis, which requires performing colonoscopy with biopsy. The etiology of MC is incompletely understood, but current theories in pathogenesis inform management strategies. The goals of management in pediatric MC should be to achieve symptomatic improvement while minimizing adverse effects of treatment. Many patients who achieve clinical response have symptomatic recurrence after discontinuation of initial therapy, and may require maintenance medication therapy to sustain remission. This review aims to summarize the epidemiology and risk factors, clinical features, diagnosis, theories regarding pathogenesis, and suggested management approaches for MC in the pediatric population.
显微镜下结肠炎（MC）是结肠的一种炎症性疾病，其特征为慢性水样腹泻，尽管结肠黏膜的内镜表现正常，但具有独特的组织学发现。MC 是老年人腹泻的常见原因，但在儿童和青少年中很少见。由于 MC 在儿科人群中罕见，且临床表现不特异，因此儿科临床医生和病理学家提高对该病的认识对于及时诊断至关重要，这需要进行结肠镜检查和活检。MC 的病因尚不完全清楚，但发病机制的现有理论为治疗策略提供了信息。儿科 MC 的治疗目标应该是在减轻治疗副作用的同时，改善症状。许多在初始治疗后症状缓解的患者在停药后会出现症状复发，可能需要维持药物治疗以维持缓解。本文旨在总结儿科 MC 的流行病学和危险因素、临床特征、诊断、发病机制理论以及治疗方法。
