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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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