title: Association of lymphocytic colitis and lactase deficiency in pediatric population.
abstract: Characterized by colonic mucosa intraepithelial lymphocytosis, lymphocytic colitis is primarily an entity presented in the middle-aged to elderly patient population. Very few large series of lymphocytic colitis of childhood occurrence are available in the medical literature. Ten cases each of lymphocytic colitis and of colonic lymphocytosis of other diagnosis, all with duodenal disaccharidases analysis data, were collected from the files of our institution. The electronic medical records were reviewed and multiple variables were analyzed. The ten patients with lymphocytic colitis presented with diarrhea. Of these, three had abdominal pain. The age range was 2-18 years. Nearly all patients were Caucasian (90%) and 70% were female. Endoscopically, most had normal appearing colonic mucosa. Significant past medical history, family medical history and associated comorbidities included celiac disease, Down syndrome, juvenile arthritis and other autoimmune diseases. Interestingly, the most revealing observation was that the majority of cases (80%) were associated with lactase deficiency and, for the most part, gastrointestinal symptoms improved simply by treatment with Lactaid or avoidance of dairy products. This association is statistically significant. Our clinicopathological study indicates that the typical pediatric patient is a female Caucasian. A large of portion of the patients had associated lactase deficiency and improved on Lactaid supplement alone.
authors.affiliation: Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Riley Hospital for Children at IU Health, 702 Barnhill Drive, Indianapolis, IN 46202, USA.
authors.forename: Jihong
authors.initials: J
authors.lastname: Sun
authors.affiliation: Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Riley Hospital for Children at IU Health, 702 Barnhill Drive, Indianapolis, IN 46202, USA.
authors.forename: Jingmei
authors.initials: J
authors.lastname: Lin
authors.affiliation: Division of Pediatric Gastroenterology/Hepatology/Nutrition, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Kalayan
authors.initials: K
authors.lastname: Parashette
authors.affiliation: Department of Epidemiology, Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Riley Hospital for Children at IU Health, 702 Barnhill Drive, Indianapolis, IN 46202, USA. Electronic address: fanr@iupui.edu.
authors.forename: Rong
authors.initials: R
authors.lastname: Fan
mesh_terms: D000293:Adolescent; D002239:Carbohydrate Metabolism, Inborn Errors / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D046730:Colitis, Lymphocytic / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D003113:Colonoscopy; D003131:Combined Modality Therapy; D004035:Diet Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D043322:Lactase / Q000172:deficiency*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D001616:beta-Galactosidase / Q000627:therapeutic use
chemical_list: D043322:Lactase; D001616:beta-Galactosidase
keywords: Chronic diarrhea; Lactase deficiency; Lactose intolerance; Lymphocytic colitis; Microscopic colitis