title: Distinct colonoscopy findings of microscopic colitis: not so microscopic after all?
abstract: Microscopic colitis (MC) is considered an "umbrella term", comprising two subtypes, i.e., collagenous colitis (CC) and lymphocytic colitis (LC). They are classically associated with normal or unremarkable colonoscopy. In the last few years, reports have been published revealing findings that are thought to be characteristic or pathognomonic of MC, especially CC. A systematic electronic and manual search of PubMed and EMBASE (to December 2010), for publications on distinct endoscopic findings in MC, resulted in 42 relevant reports for inclusion in this review. Eighty eight patients with collagenous colitis were presented. Only one publication describing a distinct endoscopic pattern in LC was found. Typical findings in CC are alteration of the vascular mucosal pattern, mucosal nodularity, a sequence of change from mucosal defects to mucosal cicatricial lesions, and perhaps (although of doubtful relevance) mucosal pseudomembranes. A causal connection of mucosal defects with the use of lansoprazole seems to exist. Adoption of the proposed lesion description herein is recommended in order to improve homogeneity of future reports.
authors.affiliation: Endoscopy Unit, Centre for Liver and Digestive Disorders, The Royal Infirmary of Edinburgh, EH164SA Edinburgh, Scotland, UK. akoulaouzidis@hotmail.com
authors.forename: Anastasios
authors.initials: A
authors.lastname: Koulaouzidis
authors.forename: Athar A
authors.initials: AA
authors.lastname: Saeed
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D046729:Colitis, Collagenous / Q000175:diagnosis / Q000473:pathology; D046730:Colitis, Lymphocytic / Q000175:diagnosis / Q000473:pathology; D046728:Colitis, Microscopic / Q000175:diagnosis* / Q000473:pathology*; D003113:Colonoscopy; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
references.citation: Endoscopy. 2008 Sep;40 Suppl 2:E162
references.pmid: 18668451
references.citation: Histopathology. 2010 Sep;57(3):427-35
references.pmid: 20840672
references.citation: Clin J Gastroenterol. 2010 Feb;3(1):18-21
references.pmid: 26189901
references.citation: Dig Liver Dis. 2011 May;43(5):380-5
references.pmid: 21195042
references.citation: Am J Surg Pathol. 2003 Oct;27(10):1375-9
references.pmid: 14508399
references.citation: Clin Gastroenterol Hepatol. 2010 Nov;8(11):A28
references.pmid: 20601144
references.citation: Gut. 2003 Apr;52(4):613; author reply 613
references.pmid: 12631686
references.citation: Gastrointest Endosc. 2005 Jan;61(1):37-45
references.pmid: 15672054
references.citation: Neth J Med. 2009 Feb;67(2):41-5
references.pmid: 19299845
references.citation: J Clin Gastroenterol. 2004 Apr;38(4):341-5
references.pmid: 15087693
references.citation: J Gastroenterol. 2003;38(8):812-3
references.pmid: 14505141
references.citation: Am J Gastroenterol. 2009 Jul;104(7):1846-7; author reply 1847
references.pmid: 19436277
references.citation: Endoscopy. 2006 May;38(5):549
references.pmid: 16767605
references.citation: Scand J Gastroenterol. 2007 Apr;42(4):530-3
references.pmid: 17454866
references.citation: Endoscopy. 1998 Sep;30(7):S80-1
references.pmid: 9826156
references.citation: World J Gastroenterol. 2008 Dec 28;14(48):7280-8
references.pmid: 19109861
references.citation: J Am Coll Surg. 2007 Nov;205(5):725
references.pmid: 17964451
references.citation: J Clin Gastroenterol. 1993 Jul;17(1):84-5
references.pmid: 8409306
references.citation: Gut. 2002 Oct;51(4):600
references.pmid: 12235088
references.citation: Endoscopy. 2010;42 Suppl 2:E117
references.pmid: 20306401
references.citation: Gastrointest Endosc. 2010 Jan;71(1):221-2; author reply 222
references.pmid: 20105482
references.citation: Endoscopy. 1997 Feb;29(2):135
references.pmid: 9101158
references.citation: Endoscopy. 2001 Jul;33(7):629-32
references.pmid: 11473337
references.citation: Endoscopy. 2009;41 Suppl 2:E281-2
references.pmid: 19866430
references.citation: Gastrointest Endosc. 2008 Jun;67(7):1185-91
references.pmid: 18513560
references.citation: Gut. 2004 Mar;53(3):346-50
references.pmid: 14960513
references.citation: Am J Gastroenterol. 2009 Nov;104(11):2866
references.pmid: 19888256
references.citation: Endoscopy. 2010;42 Suppl 2:E9-10
references.pmid: 20066608
references.citation: Pathol Eur. 1976;11(1):87-9
references.pmid: 934705
references.citation: Dig Dis Sci. 2004 Nov-Dec;49(11-12):1763-7
references.pmid: 15628699
references.citation: Clin Gastroenterol Hepatol. 2009 Sep;7(9):e57
references.pmid: 18691941
references.citation: Can J Gastroenterol. 2001 Apr;15(4):265-7
references.pmid: 11331929
references.citation: Endoscopy. 2008 Oct;40(10):878; author reply 878-9
references.pmid: 18828090
references.citation: Gastrointest Endosc. 1993 Mar-Apr;39(2):192-4
references.pmid: 8495846
references.citation: Gut. 1984 Oct;25(10):1085-8
references.pmid: 6479682
references.citation: Eur J Gastroenterol Hepatol. 2003 Sep;15(9):1051-3
references.pmid: 12923382
references.citation: Gastrointest Endosc. 2009 May;69(6):1186-8
references.pmid: 19152884
references.citation: Scand J Gastroenterol. 2006 Jun;41(6):726-9
references.pmid: 16716973
references.citation: Gastroenterol Clin Biol. 2004 Mar;28(3):310-1
references.pmid: 15094685
references.citation: Scand J Gastroenterol. 1998 Jan;33(1):2-9
references.pmid: 9489900
references.citation: Aliment Pharmacol Ther. 2010 Nov;32(9):1124-8
references.pmid: 21039674
references.citation: Hum Pathol. 1989 Jan;20(1):18-28
references.pmid: 2912870
references.citation: Dig Dis Sci. 1990 Feb;35(2):257-60
references.pmid: 2302984
references.citation: Am J Gastroenterol. 2003 Aug;98(8):1834-7
references.pmid: 12907340
references.citation: Surg Endosc. 2010 Dec;24(12):2930-4
references.pmid: 20464421
references.citation: Am J Gastroenterol. 2008 Oct;103(10):2598-604
references.pmid: 18702648
references.citation: World J Gastroenterol. 2009 May 7;15(17):2166-9
references.pmid: 19418592
references.citation: Mayo Clin Proc. 2003 May;78(5):614-6; quiz 616-7
references.pmid: 12744549
references.citation: Inflamm Bowel Dis. 2004 Nov;10(6):860-70
references.pmid: 15626904
references.citation: Rev Esp Enferm Dig. 1999 Feb;91(2):93-104
references.pmid: 10231301
references.citation: J Crohns Colitis. 2010 Jun;4(2):139-43
references.pmid: 21122497
references.citation: Endoscopy. 2007 May;39(5):459-61
references.pmid: 17516354
references.citation: Endoscopy. 2008 Apr;40(4):353; author reply 353
references.pmid: 18389454
references.citation: Gut. 2003 Apr;52(4):613-4; author reply 614
references.pmid: 12631685
references.citation: Dig Dis Sci. 1991 Jun;36(6):705-11
references.pmid: 2032511
references.citation: Intern Med. 1995 Mar;34(3):195-8
references.pmid: 7787327