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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = Collagenous_colitis_-_high_mag.jpg | | Image = Collagenous_colitis_-_high_mag.jpg | ||
| Width = | | Width = | ||
| Caption = Collagenous colitis. [[H&E stain]]. | | Caption = Collagenous colitis. [[H&E stain]]. | ||
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Notes: | Notes: | ||
*Clinical DDx includes [[irritable bowel syndrome]] - which has no or subtle histopathologic changes. | *Clinical DDx includes [[irritable bowel syndrome]] - which has no or subtle histopathologic changes. | ||
*This pathology also afflicits rectum; however, it is less commonly found there. | |||
**The rectum is afflicted in approximately in 65% of cases.<ref name=pmid12018911>{{cite journal |author=Agnarsdottir M, Gunnlaugsson O, Orvar KB, ''et al.'' |title=Collagenous and lymphocytic colitis in Iceland |journal=Dig. Dis. Sci. |volume=47 |issue=5 |pages=1122–8 |year=2002 |month=May |pmid=12018911 |doi= |url=}}</ref> | |||
===Epidemiology=== | ===Epidemiology=== | ||
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**CC females:males = 20:1.<ref name=medscape180664/> | **CC females:males = 20:1.<ref name=medscape180664/> | ||
*Drugs are associated with LC and CC. | *Drugs are associated with LC and CC. | ||
** | **[[NSAID]]s - posulated association/weak association, | ||
**SSRIs (used primarily for depression) - moderate association, dependent on specific drug. | **SSRIs (used primarily for depression) - moderate association, dependent on specific drug. | ||
*Associated with autoimmune disorders - [[celiac disease]], [[diabetes mellitus]], [[thyroid]] disorders and [[arthritis]].<ref name=pmid19109861>{{cite journal |author=Tysk C, Bohr J, Nyhlin N, Wickbom A, Eriksson S |title=Diagnosis and management of microscopic colitis |journal=World J. Gastroenterol. |volume=14 |issue=48 |pages=7280-8 |year=2008 |month=December |pmid=19109861 |doi= |url=http://www.wjgnet.com/1007-9327/14/7280.asp}}</ref> | *Associated with autoimmune disorders - [[celiac disease]], [[diabetes mellitus]], [[thyroid]] disorders and [[arthritis]].<ref name=pmid19109861>{{cite journal |author=Tysk C, Bohr J, Nyhlin N, Wickbom A, Eriksson S |title=Diagnosis and management of microscopic colitis |journal=World J. Gastroenterol. |volume=14 |issue=48 |pages=7280-8 |year=2008 |month=December |pmid=19109861 |doi= |url=http://www.wjgnet.com/1007-9327/14/7280.asp}}</ref> | ||
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==Microscopic== | ==Microscopic== | ||
Features: | Features: | ||
*Intraepithelial lymphocytes - '''important'''. | *[[Intraepithelial lymphocytes]] - '''important'''. | ||
*Collagenous material in the lamina propria (pink on H&E) -- '''key feature'''. | *Collagenous material in the lamina propria (pink on H&E) -- '''key feature'''. | ||
**Can be demonstrated with a trichrome stain -- collagen = green on trichrome. | **Can be demonstrated with a trichrome stain -- collagen = green on trichrome. | ||
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**No crypt distortion. | **No crypt distortion. | ||
*Thickened collagen band uncommon in rectum.<ref name=pmid1740280>{{Cite journal | last1 = Tanaka | first1 = M. | last2 = Mazzoleni | first2 = G. | last3 = Riddell | first3 = RH. | title = Distribution of collagenous colitis: utility of flexible sigmoidoscopy. | journal = Gut | volume = 33 | issue = 1 | pages = 65-70 | month = Jan | year = 1992 | doi = | PMID = 1740280 }}</ref> | *Thickened collagen band uncommon in rectum.<ref name=pmid1740280>{{Cite journal | last1 = Tanaka | first1 = M. | last2 = Mazzoleni | first2 = G. | last3 = Riddell | first3 = RH. | title = Distribution of collagenous colitis: utility of flexible sigmoidoscopy. | journal = Gut | volume = 33 | issue = 1 | pages = 65-70 | month = Jan | year = 1992 | doi = | PMID = 1740280 }}</ref> | ||
*Described in association of [[pseudomembranous colitis|pseudomembranes]].<ref name=pmid14508399>{{Cite journal | last1 = Yuan | first1 = S. | last2 = Reyes | first2 = V. | last3 = Bronner | first3 = MP. | title = Pseudomembranous collagenous colitis. | journal = Am J Surg Pathol | volume = 27 | issue = 10 | pages = 1375-9 | month = Oct | year = 2003 | doi = | PMID = 14508399 }}</ref> | |||
DDx: | DDx: | ||
*[[Lymphocytic colitis]]. | *[[Lymphocytic colitis]]. | ||
*[[Crohn's disease]] - may be a perfect mimic.<ref name=pmid10478667>{{Cite journal | last1 = Goldstein | first1 = NS. | last2 = Gyorfi | first2 = T. | title = Focal lymphocytic colitis and collagenous colitis: patterns of Crohn's colitis? | journal = Am J Surg Pathol | volume = 23 | issue = 9 | pages = 1075-81 | month = Sep | year = 1999 | doi = | PMID = 10478667 }}</ref> | *[[Crohn's disease]] - very rare, may be a perfect mimic.<ref name=pmid10478667>{{Cite journal | last1 = Goldstein | first1 = NS. | last2 = Gyorfi | first2 = T. | title = Focal lymphocytic colitis and collagenous colitis: patterns of Crohn's colitis? | journal = Am J Surg Pathol | volume = 23 | issue = 9 | pages = 1075-81 | month = Sep | year = 1999 | doi = | PMID = 10478667 }}</ref> | ||
===Images=== | ===Images=== |
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