Generic placeholder image

New Emirates Medical Journal

Editor-in-Chief
ISSN (Online): 0250-6882

Case Report

Collagenous Colitis associated with Celiac Disease

Author(s): Maher Malaeb*, Sameera Mahboub and Aly Howeedy

Volume 4, Issue 2, 2023

Published on: 18 July, 2023

Article ID: e150523216889 Pages: 6

DOI: 10.2174/0250688204666230515090441

Price: $0

Abstract

Introduction: Microscopic colitis is an inflammatory GI condition whereby patients present predominantly with chronic watery diarrhea associated with other non-specific symptoms such as abdominal pain, urgency, fecal incontinence, weight loss, arthralgia, myalgia, anxiety, depression, and fatigue, which negatively impact their quality of life.

Case Presentation: We present a case of a 44 -year old female with a history of hypothyroidism and celiac disease who presented to the GI clinic with a history of more than ten diarrhea episodes per day along with mild abdominal pain and bloating.

Conclusion: A colonoscopy was performed, and a random colon biopsy revealed collagenous/microscopic colitis.

[1]
Pardi DS. Diagnosis and management of microscopic colitis. Am J Gastroenterol 2017; 112(1): 78-85.
[http://dx.doi.org/10.1038/ajg.2016.477] [PMID: 27897155]
[2]
Miehlke S, Verhaegh B, Tontini GE, Madisch A, Langner C, Münch A. Microscopic colitis: Pathophysiology and clinical management. Lancet Gastroenterol Hepatol 2019; 4(4): 305-14.
[http://dx.doi.org/10.1016/S2468-1253(19)30048-2] [PMID: 30860066]
[3]
Loftus E. Microscopic colitis: Epidemiology and treatment. Am J Gastroenterol 2003; 98(12): S31-6.
[http://dx.doi.org/10.1016/j.amjgastroenterol.2003.10.008]
[4]
Storr MA. Microscopic colitis: Epidemiology, pathophysiology, diagnosis and current management-an update 2013. ISRN Gastroenterol 2013; 2013: 1-12.
[http://dx.doi.org/10.1155/2013/352718] [PMID: 23691336]
[5]
Turner K, Genta RM, Sonnenberg A. Ethnic distribution of microscopic colitis in the United States. Inflamm Bowel Dis 2015; 21(11): 2634-9.
[http://dx.doi.org/10.1097/MIB.0000000000000520] [PMID: 26226142]
[6]
Aziz M, Haghbin H, Khan RS, et al. Celiac disease is associated with microscopic colitis in refractory cases in adults: A systematic review and meta-analysis of observational studies. Dig Dis Sci 2022; 67(8): 3529-42.
[http://dx.doi.org/10.1007/s10620-021-07232-7] [PMID: 34448981]
[7]
Münch A, Aust D, Bohr J, et al. Microscopic colitis: Current status, present and future challenges. J Crohn’s Colitis 2012; 6(9): 932-45.
[http://dx.doi.org/10.1016/j.crohns.2012.05.014] [PMID: 22704658]
[8]
Green PHR, Yang J, Cheng J, Lee AR, Harper JW, Bhagat G. An association between microscopic colitis and celiac disease. Clin Gastroenterol Hepatol 2009; 7(11): 1210-6.
[http://dx.doi.org/10.1016/j.cgh.2009.07.011] [PMID: 19631283]
[9]
Sebastian S, Wilhelm A, Jessica L, Myers S, Veysey M. Budesonide treatment for microscopic colitis: systematic review and meta-analysis. Eur J Gastroenterol Hepatol 2019; 31(8): 919-27.
[http://dx.doi.org/10.1097/MEG.0000000000001456] [PMID: 31211724]
[10]
Kafil TS, Nguyen TM, Patton PH, MacDonald JK, Chande N, McDonald JW. Interventions for treating collagenous colitis. Cochrane Database Syst Rev 2017; 11(11): CD003575.
[PMID: 29127772]
[11]
Shor J, Churrango G, Hosseini N, Marshall C. Management of microscopic colitis: Challenges and solutions. Clin Exp Gastroenterol 2019; 12: 111-20.
[http://dx.doi.org/10.2147/CEG.S165047] [PMID: 30881078]
[12]
Pardi DS, Loftus EV Jr, Tremaine WJ, Sandborn WJ. Treatment of refractory microscopic colitis with azathioprine and 6-mercaptopurine. Gastroenterology 2001; 120(6): 1483-4.
[http://dx.doi.org/10.1053/gast.2001.23976] [PMID: 11313319]
[13]
Esteve M, Mahadevan U, Sainz E, Rodriguez E, Salas A, Fernández-Bañares F. Efficacy of anti-TNF therapies in refractory severe microscopic colitis. J Crohn’s Colitis 2011; 5(6): 612-8.
[http://dx.doi.org/10.1016/j.crohns.2011.05.001] [PMID: 22115383]
[14]
Rivière P, Münch A, Michetti P, et al. Vedolizumab in refractory microscopic colitis: An international case series. J Crohn’s Colitis 2019; 13(3): 337-40.
[http://dx.doi.org/10.1093/ecco-jcc/jjy169] [PMID: 30329034]
[15]
Datta I, Brar SS, Andrews CN, et al. Microscopic colitis: A review for the surgical endoscopist. Can J Surg 2009; 52(5): E167-72.
[PMID: 19865548]
[16]
Pardi DS, Kelly CP. Microscopic colitis. Gastroenterology 2011; 140(4): 1155-65.
[http://dx.doi.org/10.1053/j.gastro.2011.02.003] [PMID: 21303675]
[17]
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.
[http://dx.doi.org/10.1177/2050640620951905] [PMID: 33619914]
[18]
Miehlke S, Madisch A, Kupcinskas L, et al. Budesonide is more effective than mesalamine or placebo in short-term treatment of collagenous colitis. Gastroenterology 2014; 146(5): 1222-1230.e2, 2.
[http://dx.doi.org/10.1053/j.gastro.2014.01.019] [PMID: 24440672]
[19]
Calabrese C, Fabbri A, Areni A, Zahlane D, Scialpi C, Di Febo G. Mesalazine with or without cholestyramine in the treatment of microscopic colitis: Randomized controlled trial. J Gastroenterol Hepatol 2007; 22(6): 809-14.
[http://dx.doi.org/10.1111/j.1440-1746.2006.04511.x] [PMID: 17565633]
[20]
Münch A, Bohr J, Vigren L, Tysk C, Ström M. Lack of effect of methotrexate in budesonide-refractory collagenous colitis. Clin Exp Gastroenterol 2013; 6: 149-52.
[http://dx.doi.org/10.2147/CEG.S48201] [PMID: 24039441]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy