Clinical and histologic features differentiating non-relapsing colitis from first attacks of inflammatory bowel disease.
This is a study of first attacks of colitis, evaluating prospectively the overall course with repeated histologic, clinical, laboratory, and initial microbiologic examinations. Forty-two attacks of colitis could after a follow-up period of 5.5 years be separated into relapsing and non-relapsing types. Relapse was chosen as a prerequisite for a final diagnosis of inflammatory bowel disease. In the non-relapsing group 72% of the patients harboured enteropathogenic bacteria. An insidious onset of diarrhoeal symptoms was highly discriminant of inflammatory bowel disease, whereas an acute onset mostly occurred in patients with non-relapsing colitis. Macroscopic differentiation at sigmoidoscopy was not possible. Distorted crypt architecture (92%) and/or basal plasmacytosis (77%) at initial biopsies strongly indicated inflammatory bowel disease but was also found transiently in patients with infectious colitis (19%). Thus, careful microbiologic and clinical investigation and repeated histologic examinations are necessary to distinguish infectious colitis from inflammatory bowel disease.
Schumacher
G
G
Dept. of Internal Medicine, Danderyd Hospital, Sweden.
Sandstedt
B
B
Möllby
R
R
Kollberg
B
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003092:Colitis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D003937:Diagnosis, Differential; D005243:Feces / Q000166:cytology / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012812:Sigmoidoscopy; D015163:Superinfection / Q000382:microbiology