title: Focal active colitis: a prospective study of clinicopathological correlations in 90 patients.
abstract: OBJECTIVE
  Considerable controversy exists about the clinical implication of a diagnosis of focal active colitis (FAC). The aim of this study was to assess clinicopathological correlations of FAC in 90 adults, representing the largest and only prospective series of FAC.
  
  
  RESULTS
  Patients were assessed by comprehensive clinical follow-up and questionnaires. Fifteen histopathological features were scored and correlated with clinical outcome. In 24% of patients drugs, especially NSAIDs, were implicated. Infection was a probable cause in 19%. In 14 patients (15.6%), predominantly women, a diagnosis of chronic inflammatory bowel disease was ultimately made. Most were Crohn's disease, but this is the first study in which FAC has presaged an ultimate diagnosis of ulcerative colitis in adults (in two patients). A specific subtype of FAC, termed basal FAC, was significantly associated with drugs. These excepted, this study has found no histopathological parameters of FAC, such as amount, location and/or distribution, to correlate with clinical outcome or allowed selection of those patients more likely to show subsequent evidence of chronic inflammatory bowel disease.
  
  
  CONCLUSIONS
  This study has provided powerful information on the implication of a diagnosis of FAC. In a small but not inconsiderable case number, the ultimate diagnosis will be chronic inflammatory bowel disease.
authors.affiliation: Department of Gastroenterology, Gloucestershire Royal Hospital, Gloucester, UK.
authors.forename: Sharan
authors.initials: S
authors.lastname: Shetty
authors.forename: Salim M
authors.initials: SM
authors.lastname: Anjarwalla
authors.forename: Jyoti
authors.initials: J
authors.lastname: Gupta
authors.forename: Chris J W
authors.initials: CJ
authors.lastname: Foy
authors.forename: Ian S
authors.initials: IS
authors.lastname: Shaw
authors.forename: Roland M
authors.initials: RM
authors.lastname: Valori
authors.forename: Neil A
authors.initials: NA
authors.lastname: Shepherd
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003092:Colitis / Q000209:etiology / Q000473:pathology*; D003093:Colitis, Ulcerative / Q000473:pathology; D003424:Crohn Disease / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult