title: Incidence, Clinical Presentation, and Associated Factors of Microscopic Colitis in Northern France: A Population-Based Study.
abstract: To date, there are no epidemiological data on microscopic colitis (MC) in France. The aim of this study was to determine the incidence of MC in the Somme department in Northern France, to evaluate clinical characteristics, and to search for risk factors for both collagenous colitis (CC) and lymphocytic colitis (LC).
  
  
  
  Between January 1, 2005, and December 31, 2007, four pathology units in the Somme department recorded all new cases of MC diagnosed in patients living in the area. Colonic biopsies were reviewed by 4 pathologists together. For each incident case, demographic, clinical, endoscopic, and biological data were collected according to methodology of the EPIMAD registry.
  
  
  
  One hundred and thirty cases of MC, including 87 CC and 43 LC, were recorded during the three-year study. The mean annual incidence for MC was 7.9/105inhabitants, 5.3/105inhabitants for CC, and 2.6/105inhabitants for LC. Annual standardized incidence of Crohn's disease and ulcerative colitis in the EPIMAD registry during the same period (2005-2007) were 7.4/105and 4.9/105, respectively. Median age at diagnosis was 63 years for MC, 70 for CC, and 48 for LC. The female-to-male gender ratio was 3.5 for MC, 4.1 for CC, and 2.6 for LC. Median time to diagnosis was 8 weeks. Chronic diarrhea and abdominal pain were, respectively, present in 93 and 47 % of the cases. An autoimmune disease was associated in 28 % of MC cases. At diagnosis, proton pump inhibitor treatment was more often reported in CC than in LC (46 vs 16 %; p = 0.003). Budesonide was effective on diarrhea in 77 % of patients, and thirteen percent of patients became steroid dependent.
  
  
  
  This population-based study shows that the incidence of MC in France is high and similar to Crohn's disease incidence and confirms that this condition is associated with female gender, autoimmune diseases, and medications.
authors.affiliation: Service d'hepatogastroenterologie, Gastroenterology Unit, Amiens University and Hospital, Université de Picardie Jules Verne, Avenue Laennec-Salouel, 80000, Amiens, France. mathurinfumery@gmail.com.|EPIMAD registry, Amiens, France. mathurinfumery@gmail.com.
authors.forename: Mathurin
authors.initials: M
authors.lastname: Fumery
authors.affiliation: Gastroenterology, St. Isabelle Clinic, Abbeville, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Kohut
authors.affiliation: LIRIC-UMR 995 INSERM, IBD team and Environmental Factors: Epidemiology and Functional Analyses, Lille University, Lille, France.|Public Health, Epidemiology and Economic Health, EPIMAD registry, Regional Clinical Research Center, Lille University and Hospital, Cedex, France.
authors.forename: Corinne
authors.initials: C
authors.lastname: Gower-Rousseau
authors.affiliation: Biostatistics Unit, CERIM, EA2694, Lille University and Hospital, Lille, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Duhamel
authors.affiliation: Service d'hepatogastroenterologie, Gastroenterology Unit, Amiens University and Hospital, Université de Picardie Jules Verne, Avenue Laennec-Salouel, 80000, Amiens, France.|EPIMAD registry, Amiens, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Brazier
authors.affiliation: Pathology Laboratory, 40 rue Andre Chenier, 80000, Amiens, France.
authors.forename: Francoise
authors.initials: F
authors.lastname: Thelu
authors.affiliation: Pathology Laboratory, 51 Rue Jeanne d'Arc, 80000, Amiens, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Nagorniewicz
authors.affiliation: Pathology Laboratory, 13 Rue Sainte-Catherine, 80100, Abbeville, France.
authors.forename: Francois
authors.initials: F
authors.lastname: Lamarche
authors.affiliation: Service d'hepatogastroenterologie, Gastroenterology Unit, Amiens University and Hospital, Université de Picardie Jules Verne, Avenue Laennec-Salouel, 80000, Amiens, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Nguyen-Khac
authors.affiliation: Department of Digestive Surgery, Amiens University Hospital, Amiens, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Sabbagh
authors.affiliation: Service d'hepatogastroenterologie, Gastroenterology Unit, Amiens University and Hospital, Université de Picardie Jules Verne, Avenue Laennec-Salouel, 80000, Amiens, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Loreau
authors.affiliation: Dr. Henry D Janowitz, Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Jean-Frederic
authors.initials: JF
authors.lastname: Colombel
authors.affiliation: Gastroenterology Unit, EPIMAD registry, Rouen University and Hospital, Rouen, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Savoye
authors.affiliation: Pathology Unit, Amiens University and Hospital, Picardie University Jules Verne, Amiens, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Chatelain
authors.affiliation: Service d'hepatogastroenterologie, Gastroenterology Unit, Amiens University and Hospital, Université de Picardie Jules Verne, Avenue Laennec-Salouel, 80000, Amiens, France.|EPIMAD registry, Amiens, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Dupas
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000453:epidemiology*; D002908:Chronic Disease; D046729:Colitis, Collagenous / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D046730:Colitis, Lymphocytic / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D003093:Colitis, Ulcerative / Q000453:epidemiology; D015897:Comorbidity; D003424:Crohn Disease / Q000453:epidemiology; D003967:Diarrhea / Q000209:etiology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha
keywords: Collagenous colitis; Incidence; Lymphocytic colitis; Microscopic colitis; Population based