Clinical cases of microscopic colitis: Diagnosis and treatment issues. Case report

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Abstract

Currently, there is an increase in the incidence of microscopic colitis. There are difficulties in diagnosing this disease due to the variability of histological signs, variability of morphological changes in the mucous membrane of the colon in different parts of the colon, and the combination in one patient of not only various forms of microscopic colitis, but also other intestinal diseases. The article describes the differential diagnosis, an example of its staging and successful treatment of various forms of microscopic colitis with budesonide (two clinical cases presented).

About the authors

Alexey M. Osadchuk

Russian Medical Academy of Continuous Professional Education

Author for correspondence.
Email: a.m.osadchuk2020@mail.ru
ORCID iD: 0000-0002-8488-9235
Scopus Author ID: 24576966600

доктор медицинских наук, профессор, профессор кафедры гастроэнтерологии

Russian Federation, Moscow

Nina A. Fadeeva

Loginov Moscow Clinical Scientific and Practical Center; Research Institute of Health Organization and Medical Management

Email: n.fadeeva@mknc.ru
ORCID iD: 0000-0002-0524-2514
SPIN-code: 6047-7590

кандидат медицинских наук, зав. гастроэнтерологическим отделением, старший научный сотрудник отделения лечения воспалительных заболеваний кишечника, вед. специалист

Russian Federation, Moscow; Moscow

Nuriya A. Dashkina

Loginov Moscow Clinical Scientific and Practical Center

Email: n.dashkina@mknc.ru
ORCID iD: 0009-0001-6455-4921

врач-гастроэнтеролог гастроэнтерологического отделения

Russian Federation, Moscow

Irina D. Loranskaya

Russian Medical Academy of Continuous Professional Education

Email: gastromapo@yandex.ru
ORCID iD: 0000-0002-3681-4132
Scopus Author ID: 36164230100

зав. кафедры гастроэнтерологии

Russian Federation, Moscow

Sergey G. Khomeriki

Loginov Moscow Clinical Scientific and Practical Center

Email: s.khomeriki@mknc.ru
ORCID iD: 0000-0003-4308-8009

доктор медицинских наук, профессор, зав. лаб. инновационной патоморфологии ГБУЗ «МКНЦ имени А.С. Логинова»

Russian Federation, Moscow

References

  1. Miehlke S, Guagnozzi D, Zabana Y, et al. European guidelines on microscopic colitis: United European Gastroenterology and European Microscopic Colitis Group statements and recommendations. United European Gastroenterol J. 2021;9(1):13-37. doi: 10.1177/2050640620951905
  2. Nielsen JA, Steephen A, Lewin M. Angiotensin-II inhibitor (olmesartan)-induced collagenous sprue with resolution following discontinuation of drug. World J Gastroenterol. 2013;19(40):6928-30. doi: 10.3748/wjg.v19.i40.6928
  3. Jaruvongvanich V, Poonsombudlert K, Ungprasert P. Smoking and risk of microscopic colitis: A systematic review and meta-analysis. Inflamm Bowel Dis. 2019;25:672-8. doi: 10.1093/ibd/izy296
  4. Barrett K. Microscopic colitis: A guide for general practice. Br J Gen Pract. 2020;71(702):41-2. doi: 10.3399/bjgp21X714593
  5. Miehlke S, Heymer P, Bethke B, et al. Budesonide treatment for collagenous colitis: A randomized, double-blind, placebo-controlled, multicenter trial. Gastroenterology. 2002;123(4):978-84. doi: 10.1053/gast.2002.36042
  6. Bonderup OK, Hansen JB, Birket-Smith L, et al. Budesonide treatment of collagenous colitis: A randomised, double blind, placebo controlled trial with morphometric analysis. Gut. 2003;52(2):248-51. doi: 10.1136/gut.52.2.248
  7. Miehlke S, Madisch A, Kupcinskas L, et al. BUC-60/COC Study Group. Budesonide is more effective than mesalamine or placebo in short-term treatment of collagenous colitis. Gastroenterology. 2014;146(5):1222-30.e1-2. doi: 10.1053/j.gastro.2014.01.019
  8. Temmerman F., Baert F. Collagenous and lymphocytic colitis: systematic review and update of the literature. Dig Dis. 2009;27(Suppl. 1):137-45. doi: 10.1159/000268134
  9. Bonderup OK, Hansen JB, Teglbjaerg PS, et al. Long-term budesonide treatment of collagenous colitis: A randomised, double-blind, placebo-controlled trial. Gut. 2009;58(1):68-72. doi: 10.1136/gut.2008.156513
  10. Nguyen GC, Smalley WE, Vege SS, Carrasco-Labra A; Clinical Guidelines Committee. American Gastroenterological Association Institute Guideline on the medical management of microscopic colitis. Gastroenterology. 2016;150(1):242-6; quiz e17-8. doi: 10.1053/j.gastro.2015.11.008
  11. Sonnenberg A, Genta RM. Temporal changes in the histology of microscopic colitis. J Crohns Colitis. 2022;16(9):1415-9. doi: 10.1093/ecco-jcc/jjac046
  12. Khalili H, Axelrad JE, Roelstraete B, et al. Gastrointestinal infection and risk of microscopic colitis: A nationwide case-control study in Sweden. Gastroenterology. 2021;160(5):1599-607.e5. doi: 10.1053/j.gastro.2021.01.004
  13. Фадеева Н.А., Осадчук А.М., Куколева Е.О., и др. Проблемы диагностики и лечения сочетания целиакии и микроскопического колита. Эффективная фармакотерапия. 2022;18(22):112-6 [Fadeeva NA, Osadchuk AM, Kukoleva EO, et al. The problems of diagnosis and treatment the comorbidity of celiac disease and miscroscopic colitis. Effective Pharmacotherapy. 2022;18(22):112-6 (in Russian)]. doi: 10.33978/2307-3586-2022-18-22-112-116
  14. Virine B, Chande N, Driman DK. Biopsies from ascending and descending colon are sufficient for diagnosis of microscopic colitis. Clin Gastroenterol Hepatol. 2020;18(9):2003-9. doi: 10.1016/j.cgh.2020.02.036

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2. Fig. 1. Microscopic colitis treatment algorithm proposed by the American Gastroenterological Association [10]

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3. Fig. 2. Microscopic colitis treatment algorithm proposed by the European Group for Mi-croscopic Colitis [1]

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4. Fig. 3. Microscopic colitis in the form of lymphocytic colitis: a – the archtectonic of the intestinal crypt is preserved, its own plate is abundantly infiltrated by lymphocytes and plasmocytes; b – the dystrophy of surface epithelium cells. Increase in the number of interepithelial lymphocytes. Coloration of hematoxylin and eosin. Magnification of 120 (a), 300 (b).

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5. Fig. 4. Microscopic colitis in the form of collagen colitis: a – the archtectonic of the intestinal crypt is preserved, its own plate is oedematous and moderately infiltrated by lymphocytes and plasmocytes; b – dystrophy and desquamation sites of the surface epithelium cells, abrupt thickening of the basal membrane; c – increased collagen deposition in the subepithelial layer of the basal membrane. Coloration by hematoxylin and eosin (a, b), picrofuxin by Van Gizon (c). Magnification 120 (a, b), 300 (c).

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