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[PMID]:28350750
[Au] Autor:Wickbom A; Nyhlin N; Montgomery SM; Bohr J; Tysk C
[Ad] Endereço:aSchool of Medical Sciences, Örebro University, Örebro bThe Clinical Epidemiology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden cDepartment of Epidemiology and Public Health, University College London, London, UK.
[Ti] Título:Family history, comorbidity, smoking and other risk factors in microscopic colitis: a case-control study.
[So] Source:Eur J Gastroenterol Hepatol;29(5):587-594, 2017 May.
[Is] ISSN:1473-5687
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Data on heredity, risk factors and comorbidity in microscopic colitis, encompassing collagenous colitis (CC) and lymphocytic colitis (LC), are limited. AIM: The aim was to carry out a case-control study of family history, childhood circumstances, educational level, marital status, smoking and comorbidity in microscopic colitis. METHODS: A postal questionnaire was sent in 2008-2009 to microscopic colitis patients resident in Sweden and three population-based controls per patient, matched for age, sex and municipality. RESULTS: Some 212 patients and 627 controls participated in the study. There was an association with a family history of microscopic colitis in both CC [odds ratio (OR): 10.3; 95% confidence interval (CI): 2.1-50.4, P=0.004] and LC (OR not estimated, P=0.008). Current smoking was associated with CC [OR: 4.7; 95% CI: 2.4-9.2, P<0.001) and LC (OR: 3.2; 95% CI: 1.6-6.7, P=0.002). The median age at diagnosis was around 10 years earlier in ever-smokers compared with never-smokers.CC was associated with a history of ulcerative colitis (UC) (OR: 8.7, 95% CI: 2.2-33.7, P=0.002), thyroid disease (OR: 2.3; 95% CI: 1.1-4.5, P=0.02), coeliac disease (OR: 13.1; 95% CI: 2.7-62.7, P=0.001), rheumatic disease (OR 1.9; 95% CI: 1.0-3.5, P=0.042) and previous appendicectomy (OR: 2.2; 95% CI: 1.3-3.8, P=0.003), and LC with UC (OR: 6.8; 95% CI: 1.7-28.0, P=0.008), thyroid disease (OR: 2.4; 95% CI: 1.1-5.4, P=0.037) and coeliac disease (OR: 8.7; 95% CI: 2.8-26.7, P<0.001). CONCLUSION: Association with a family history of microscopic colitis indicates that familial factors may be important. The association with a history of UC should be studied further as it may present new insights into the pathogenesis of microscopic colitis and UC.
[Mh] Termos MeSH primário: Colite Microscópica/etiologia
Fumar/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Doenças Autoimunes/epidemiologia
Estudos de Casos e Controles
Colite Colagenosa/diagnóstico
Colite Colagenosa/epidemiologia
Colite Colagenosa/etiologia
Colite Colagenosa/genética
Colite Linfocítica/diagnóstico
Colite Linfocítica/epidemiologia
Colite Linfocítica/etiologia
Colite Linfocítica/genética
Colite Microscópica/diagnóstico
Colite Microscópica/epidemiologia
Colite Microscópica/genética
Colite Ulcerativa/epidemiologia
Comorbidade
Escolaridade
Feminino
Predisposição Genética para Doença
Seres Humanos
Masculino
Estado Civil
Meia-Idade
Fatores de Risco
Fumar/epidemiologia
Suécia/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170329
[St] Status:MEDLINE
[do] DOI:10.1097/MEG.0000000000000832


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[PMID]:28275312
[Au] Autor:Günaltay S; Rademacher L; Hultgren Hörnquist E; Bohr J
[Ad] Endereço:Sezin Günaltay, Elisabeth Hultgren Hörnquist, Johan Bohr, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, SE-70185 Örebro, Sweden.
[Ti] Título:Clinical and immunologic effects of faecal microbiota transplantation in a patient with collagenous colitis.
[So] Source:World J Gastroenterol;23(7):1319-1324, 2017 Feb 21.
[Is] ISSN:2219-2840
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:One to six percent of patients with microscopic colitis are refractory to medical treatment. The effect of faecal microbiota transplantation (FMT) in active collagenous colitis (CC) has, to the best of our knowledge, never been reported before. Here, we report the effect of repeated FMT in a patient with CC. The patient presented with severe symptoms including profuse diarrhea and profound weight loss. Although she responded to budesonide in the beginning, she became gradually refractory to medical treatment, and was therefore treated with FMT. The patient remained in remission for 11 mo after the third faecal transplantation. The immunomodulatory effect of the therapy was evaluated using flow cytometry, which showed alterations in the profile of intraepithelial and lamina propria lymphocyte subsets after the second transplantation. Our observations indicate that FMT can have an effect in CC, which support the hypothesis that luminal factors, influencing the intestinal microbiota, are involved in the pathogenesis of CC.
[Mh] Termos MeSH primário: Colite Colagenosa/microbiologia
Colite Colagenosa/terapia
Transplante de Microbiota Fecal
Linfócitos/citologia
[Mh] Termos MeSH secundário: Idoso
Biópsia
Colite Colagenosa/imunologia
Colite Ulcerativa/terapia
Diarreia
Fezes
Feminino
Citometria de Fluxo
Seres Humanos
Microbiota
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170814
[Lr] Data última revisão:
170814
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170310
[St] Status:MEDLINE
[do] DOI:10.3748/wjg.v23.i7.1319


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[PMID]:28260714
[Au] Autor:Ikemoto J; Nakadoi K; Onogawa S; Fukuhara M; Shishido T; Hanada K; Yonehara S
[Ad] Endereço:Department of Gastroenterology, Onomichi General Hospital.
[Ti] Título:A case of collagenous colitis associated with novel oral anticoagulants use.
[So] Source:Nihon Shokakibyo Gakkai Zasshi;114(3):456-463, 2017.
[Is] ISSN:0446-6586
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:An 84-year-old man was referred to our hospital because of watery diarrhea. Due to cerebral infarction, he had started treatment with a novel oral anticoagulants (NOAC) 1 month prior to admission. The patient underwent blood tests, enhanced computed tomography, and colonoscopy, which indicated infectious or medicinal colitis. The diarrhea persisted and he developed hypokalemia, so a second colonoscopy was performed, which showed edematous mucosa. Colonic mucosal biopsies showed a thick collagen band in the subepithelial region, and collagenous colitis was diagnosed. The watery diarrhea subsequently resolved 1 week after changing the NOAC to warfarin. Reports on collagenous colitis caused by NOAC are very rare, and we consider this case valuable.
[Mh] Termos MeSH primário: Anticoagulantes/efeitos adversos
Colite Colagenosa/induzido quimicamente
[Mh] Termos MeSH secundário: Administração Oral
Idoso de 80 Anos ou mais
Anticoagulantes/administração & dosagem
Colite Colagenosa/diagnóstico
Colonoscopia
Seres Humanos
Masculino
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171018
[Lr] Data última revisão:
171018
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170307
[St] Status:MEDLINE
[do] DOI:10.11405/nisshoshi.114.456


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[PMID]:28073828
[Au] Autor:Velayos T; Martínez R; Alonso M; Garcia-Etxebarria K; Aguayo A; Camarero C; Urrutia I; Martínez de LaPiscina I; Barrio R; Santin I; Castaño L
[Ad] Endereço:Endocrinology and Diabetes Research Group, Hospital Universitario Cruces, BioCruces Health Research Institute, CIBERDEM, CIBERER, UPV-EHU, Barakaldo, Spain.
[Ti] Título:An Activating Mutation in Results in Neonatal Diabetes Through Reduced Insulin Synthesis.
[So] Source:Diabetes;66(4):1022-1029, 2017 Apr.
[Is] ISSN:1939-327X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Neonatal diabetes mellitus (NDM) is a rare form of diabetes diagnosed within the first 6 months of life. Genetic studies have allowed the identification of several genes linked to the development of NDM; however, genetic causes for ∼20% of the cases remain to be clarified. Most cases of NDM involve isolated diabetes, but sometimes NDM appears in association with other pathological conditions, including autoimmune diseases. Recent reports have linked activating mutations in with early-onset autoimmune disorders that include diabetes of autoimmune origin, but the functional impact of -activating mutations have not been characterized at the pancreatic ß-cell level. By using whole-exome sequencing, we identified a novel missense mutation in the binding domain of the STAT3 protein in a patient with NDM. The functional analyses showed that the mutation results in an aberrant activation of STAT3, leading to deleterious downstream effects in pancreatic ß-cells. The identified mutation leads to hyperinhibition of the transcription factor Isl-1 and, consequently, to a decrease in insulin expression. These findings represent the first functional indication of a direct link between an NDM-linked activating mutation in and pancreatic ß-cell dysfunction.
[Mh] Termos MeSH primário: Hipotireoidismo Congênito/genética
Diabetes Mellitus/genética
Células Secretoras de Insulina/metabolismo
Insulina/biossíntese
Fator de Transcrição STAT3/genética
[Mh] Termos MeSH secundário: Animais
Western Blotting
Linhagem Celular
Imunoprecipitação da Cromatina
Colite Colagenosa/complicações
Hipotireoidismo Congênito/complicações
Feminino
Seres Humanos
Recém-Nascido
Proteínas com Homeodomínio LIM/metabolismo
Mutação
Mutação de Sentido Incorreto
Ratos
Reação em Cadeia da Polimerase em Tempo Real
Análise de Sequência de DNA
Fatores de Transcrição/metabolismo
Transfecção
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Insulin); 0 (LIM-Homeodomain Proteins); 0 (STAT3 Transcription Factor); 0 (STAT3 protein, human); 0 (Stat3 protein, rat); 0 (Transcription Factors); 0 (insulin gene enhancer binding protein Isl-1)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170613
[Lr] Data última revisão:
170613
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170112
[St] Status:MEDLINE
[do] DOI:10.2337/db16-0867


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[PMID]:27897155
[Au] Autor:Pardi DS
[Ad] Endereço:Inflammatory Bowel Disease Clinic, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
[Ti] Título:Diagnosis and Management of Microscopic Colitis.
[So] Source:Am J Gastroenterol;112(1):78-85, 2017 Jan.
[Is] ISSN:1572-0241
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Microscopic colitis (MC) is a relatively common cause of chronic watery diarrhea, especially in older persons. Associated symptoms, including abdominal pain and arthralgias, are common. The diagnosis is based upon characteristic histological findings in the presence of diarrhea. The two types of MC, collagenous and lymphocytic colitis, share similar clinical features, with the main difference being the presence or absence of a thickened subepithelial collagen band. There are several treatment options for patients with MC, although only budesonide has been well studied in multiple controlled clinical trials. This review will describe the clinical features, epidemiology, pathophysiology, diagnostic criteria, and treatment of patients with MC.
[Mh] Termos MeSH primário: Colite Colagenosa/diagnóstico
Colite Linfocítica/diagnóstico
[Mh] Termos MeSH secundário: Resinas de Troca de Ânions/uso terapêutico
Anti-Inflamatórios não Esteroides/uso terapêutico
Antidiarreicos/uso terapêutico
Autoimunidade/imunologia
Ácidos e Sais Biliares/metabolismo
Budesonida/uso terapêutico
Resina de Colestiramina/uso terapêutico
Colite Colagenosa/tratamento farmacológico
Colite Colagenosa/imunologia
Colite Colagenosa/patologia
Colite Linfocítica/tratamento farmacológico
Colite Linfocítica/imunologia
Colite Linfocítica/patologia
Colite Microscópica/diagnóstico
Colite Microscópica/tratamento farmacológico
Colite Microscópica/imunologia
Colite Microscópica/patologia
Colágeno/metabolismo
Colo/patologia
Predisposição Genética para Doença
Glucocorticoides/uso terapêutico
Antígenos HLA/genética
Antígenos HLA/imunologia
Seres Humanos
Mesalamina/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anion Exchange Resins); 0 (Anti-Inflammatory Agents, Non-Steroidal); 0 (Antidiarrheals); 0 (Bile Acids and Salts); 0 (Glucocorticoids); 0 (HLA Antigens); 11041-12-6 (Cholestyramine Resin); 4Q81I59GXC (Mesalamine); 51333-22-3 (Budesonide); 9007-34-5 (Collagen)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170620
[Lr] Data última revisão:
170620
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161130
[St] Status:MEDLINE
[do] DOI:10.1038/ajg.2016.477


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[PMID]:27659673
[Au] Autor:Fumery M; Kohut M; Gower-Rousseau C; Duhamel A; Brazier F; Thelu F; Nagorniewicz F; Lamarche F; Nguyen-Khac E; Sabbagh C; Loreau J; Colombel JF; Savoye G; Chatelain D; Dupas JL; On behalf on the Somme MC group; EPIMAD group
[Ad] Endereço:Service d'hepatogastroenterologie, Gastroenterology Unit, Amiens University and Hospital, Université de Picardie Jules Verne, Avenue Laennec-Salouel, 80000, Amiens, France. mathurinfumery@gmail.com.
[Ti] Título:Incidence, Clinical Presentation, and Associated Factors of Microscopic Colitis in Northern France: A Population-Based Study.
[So] Source:Dig Dis Sci;62(6):1571-1579, 2017 Jun.
[Is] ISSN:1573-2568
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: 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). DESIGN: 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. RESULTS: 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. CONCLUSION: 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.
[Mh] Termos MeSH primário: Doenças Autoimunes/epidemiologia
Colite Colagenosa/tratamento farmacológico
Colite Colagenosa/epidemiologia
Colite Linfocítica/tratamento farmacológico
Colite Linfocítica/epidemiologia
[Mh] Termos MeSH secundário: Dor Abdominal/etiologia
Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Anti-Inflamatórios/uso terapêutico
Doença Crônica
Colite Colagenosa/complicações
Colite Linfocítica/complicações
Colite Ulcerativa/epidemiologia
Comorbidade
Doença de Crohn/epidemiologia
Diarreia/etiologia
Feminino
França/epidemiologia
Seres Humanos
Imunossupressores/uso terapêutico
Incidência
Masculino
Meia-Idade
Fatores de Risco
Fatores Sexuais
Fator de Necrose Tumoral alfa/antagonistas & inibidores
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 0 (Immunosuppressive Agents); 0 (Tumor Necrosis Factor-alpha)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160924
[St] Status:MEDLINE
[do] DOI:10.1007/s10620-016-4306-z


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[PMID]:27620860
[Au] Autor:Lan N; Shen B; Yuan L; Liu X
[Ad] Endereço:Departments of Gastroenterology/Hepatology, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
[Ti] Título:Comparison of clinical features, treatment, and outcomes of collagenous sprue, celiac disease, and collagenous colitis.
[So] Source:J Gastroenterol Hepatol;32(1):120-127, 2017 Jan.
[Is] ISSN:1440-1746
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Collagenous sprue (CS) is a rare form of enteropathy that had been reported to be associated with celiac disease (CD) and collagenous colitis (CC). The aim of our study was to compare the clinical features, treatments, and outcomes of CS, CD, and CC. METHODS: All patients with histologic diagnosis of CS, CD, or CC with complete clinical data were extracted from our pathology database between 1990 and 2015. Demographic and clinical features were recorded along with treatments and outcomes. RESULTS: A total of 21 patients with CS were included. Overall CS patients were more symptomatic with 17 (81.0%) patients with diarrhea and 15 (71.4%) with unintentional weight loss. Positive celiac serology was noted in 5 (23.8%) CS patients. CS patients had higher rates for disease-related temporary total parenteral nutrition (TPN) use (38.1% vs. 1.1% vs. 1.0%, P < 0.0001) and disease-related hospitalization (52.4% vs. 3.3% vs. 8.2%, P < 0.0001) than that in CD and CC patients. Twenty CS patients received treatments, including the combination of gluten-free diet (GFD) and corticosteroids (n = 12), GFD only (n = 2), and corticosteroids only (n = 6). All CS patients showed symptomatic reliefs with treatment. Although CS patients had a higher rate for hospitalization and TPN use, disease-related death was not observed in all three groups. CONCLUSIONS: Collagenous sprue patients had more severe clinical presentation than patients with CD and CC and therefore had higher demand for temporary TPN and hospitalization. Nevertheless, a prompt use of steroids and/or GFD upon histologic diagnosis of CS may have contributed to an overall excellent prognosis.
[Mh] Termos MeSH primário: Doença Celíaca
Colite Colagenosa
Espru Colágeno
[Mh] Termos MeSH secundário: Corticosteroides/uso terapêutico
Idoso
Doença Celíaca/terapia
Colite Colagenosa/terapia
Espru Colágeno/terapia
Diarreia
Dieta Livre de Glúten
Feminino
Hospitalização/estatística & dados numéricos
Seres Humanos
Masculino
Meia-Idade
Nutrição Parenteral Total/estatística & dados numéricos
Prognóstico
Perda de Peso
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170728
[Lr] Data última revisão:
170728
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160914
[St] Status:MEDLINE
[do] DOI:10.1111/jgh.13592


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[PMID]:26525574
[Au] Autor:Westerlind H; Mellander MR; Bresso F; Munch A; Bonfiglio F; Assadi G; Rafter J; Hübenthal M; Lieb W; Källberg H; Brynedal B; Padyukov L; Halfvarson J; Törkvist L; Bjork J; Andreasson A; Agreus L; Almer S; Miehlke S; Madisch A; Ohlsson B; Löfberg R; Hultcrantz R; Franke A; D'Amato M
[Ad] Endereço:Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
[Ti] Título:Dense genotyping of immune-related loci identifies HLA variants associated with increased risk of collagenous colitis.
[So] Source:Gut;66(3):421-428, 2017 Mar.
[Is] ISSN:1468-3288
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Collagenous colitis (CC) is a major cause of chronic non-bloody diarrhoea, particularly in the elderly female population. The aetiology of CC is unknown, and still poor is the understanding of its pathogenesis. This possibly involves dysregulated inflammation and immune-mediated reactions in genetically predisposed individuals, but the contribution of genetic factors to CC is underinvestigated. We systematically tested immune-related genes known to impact the risk of several autoimmune diseases for their potential CC-predisposing role. DESIGN: Three independent cohorts of histologically confirmed CC cases (N=314) and controls (N=4299) from Sweden and Germany were included in a 2-step association analysis. Immunochip and targeted single nucleotide polymorphism (SNP) genotype data were produced, respectively, for discovery and replication purposes. Classical human leucocyte antigen (HLA) variants at 2-digit and 4-digit resolution were obtained via imputation from single marker genotypes. SNPs and HLA variants passing quality control filters were tested for association with CC with logistic regression adjusting for age, sex and country of origin. RESULTS: Forty-two markers gave rise to genome-wide significant association signals, all contained within the HLA region on chromosome 6 (best p=4.2×10 for SNP rs4143332). Among the HLA variants, most pronounced risk effects were observed for 8.1 haplotype alleles including DQ2.5, which was targeted and confirmed in the replication data set (p=2.3×10 ; OR=2.06; 95% CI (1.67 to 2.55) in the combined analysis). CONCLUSIONS: HLA genotype associates with CC, thus implicating HLA-related immune mechanisms in its pathogenesis.
[Mh] Termos MeSH primário: Colite Colagenosa/genética
Colite Colagenosa/imunologia
Loci Gênicos
Predisposição Genética para Doença
Antígenos HLA/genética
Antígenos HLA/imunologia
[Mh] Termos MeSH secundário: Idoso
Alelos
Estudos de Casos e Controles
Cromossomos Humanos Par 6
Feminino
Técnicas de Genotipagem
Haplótipos
Seres Humanos
Masculino
Meia-Idade
Polimorfismo de Nucleotídeo Único
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (HLA Antigens)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170707
[Lr] Data última revisão:
170707
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:151104
[St] Status:MEDLINE
[do] DOI:10.1136/gutjnl-2015-309934


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[PMID]:27784958
[Au] Autor:Guagnozzi D; Landolfi S; Vicario M
[Ad] Endereço:Danila Guagnozzi, Department of Gastroenterology, Hospital Universitario Vall d'Hebron, 08035 Barcelona, Spain.
[Ti] Título:Towards a new paradigm of microscopic colitis: Incomplete and variant forms.
[So] Source:World J Gastroenterol;22(38):8459-8471, 2016 Oct 14.
[Is] ISSN:2219-2840
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Microscopic colitis (MC) is a chronic inflammatory bowel disease that has emerged in the last three decades as a leading cause of chronic watery diarrhoea. MC classically includes two main subtypes: lymphocytic colitis (LC) and collagenous colitis (CC). Other types of histopathological changes in the colonic mucosa have been described in patients with chronic diarrhoea, without fulfilling the conventional histopathological criteria for MC diagnosis. Whereas those unclassified alterations remained orphan for a long time, the use of the term incomplete MC (MCi) is nowadays universally accepted. However, it is still unresolved whether CC, LC and MCi should be considered as one clinical entity or if they represent three related conditions. In contrast to classical MC, the real epidemiological impact of MCi remains unknown, because only few epidemiological studies and case reports have been described. MCi presents clinical characteristics indistinguishable from complete MC with a good response to budesonide and cholestiramine. Although a number of medical treatments have been assayed in MC patients, currently, there is no causal treatment approach for MC and MCi, and only empirical strategies have been performed. Further studies are needed in order to identify their etiopathogenic mechanisms, and to better classify and treat MC.
[Mh] Termos MeSH primário: Colite Colagenosa/diagnóstico
Colite Linfocítica/diagnóstico
Colo/patologia
Mucosa Intestinal/patologia
[Mh] Termos MeSH secundário: Biópsia/efeitos adversos
Budesonida/uso terapêutico
Resina de Colestiramina/uso terapêutico
Colite Colagenosa/classificação
Colite Colagenosa/epidemiologia
Colite Linfocítica/classificação
Colite Linfocítica/epidemiologia
Colágeno/química
Diagnóstico Diferencial
Diarreia/diagnóstico
Seres Humanos
Imuno-Histoquímica
Doenças Inflamatórias Intestinais/diagnóstico
Fatores Sexuais
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
11041-12-6 (Cholestyramine Resin); 51333-22-3 (Budesonide); 9007-34-5 (Collagen)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170627
[Lr] Data última revisão:
170627
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161028
[St] Status:MEDLINE


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[PMID]:27716080
[Au] Autor:Mitchell A; Dugas A
[Ad] Endereço:Department of Anatomic Pathology and Cytology, Maisonneuve-Rosemont Hospital, 5415 Boulevard de L'Assomption, Montreal, Quebec, H1T 2X1, Canada. plaines@me.com.
[Ti] Título:Collagenous colitis presenting as spontaneous perforation in an 80 year old woman: Report of a Case.
[So] Source:BMC Gastroenterol;16(1):124, 2016 Oct 06.
[Is] ISSN:1471-230X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Perforation of the colon occurring during or shortly following colonoscopy or barium enema is a rare complication of collagenous colitis (CC). "Spontaneous" perforation in CC, in which no instigating factor is identified, is even less common, with only five cases reported to date. We report herein an additional case of spontaneous perforation in previously undiagnosed CC and review the clinical and pathological features of previously reported cases. CASE PRESENTATION: An 80 year old woman presented to the emergency department with abdominal pain preceded by approximately one month of frequent non-bloody diarrhea. Abdominal CT showed parietal thickening of the colon at the splenic flexure with pneumatosis and signs of perforation. Segmental resection was performed. Pathologic examination showed the microscopic findings typical of CC complicated by several deep ulcers and perforation. One day following discharge from hospital abdominal pain and frequent non-bloody diarrhea recurred. The patient was managed conservatively and treated with oral budesonide with resulting resolution of symptoms. CONCLUSIONS: Spontaneous perforation is a rare and serious complication of CC. All patients to date have been female. In contrast to procedure-related perforation, which favors the right colon, spontaneous perforation in CC has in all cases involved the left colon. Knowledge of spontaneous perforation as a potential complication of previously undiagnosed CC may be helpful in the evaluation and management of patients presenting with colonic perforation, especially those with risk factors for CC.
[Mh] Termos MeSH primário: Colite Colagenosa/complicações
Perfuração Intestinal/etiologia
Perfuração Espontânea/etiologia
[Mh] Termos MeSH secundário: Dor Abdominal/etiologia
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170220
[Lr] Data última revisão:
170220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161008
[St] Status:MEDLINE



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