title: Microscopic colitis in patients with mild duodenal damage: A new clinical and pathological entity ("lymphocytic enterocolitis")?
abstract: OBJECTIVE
  To evaluate the potential association between mild duodenal damage and microscopic colitis (MC).
  
  
  METHODS
  We retrospectively included 105 consecutive patients with type I Marsh-Oberhuber duodenal damage and negativity for immunoglobulin A anti-endomysium and anti-tissue transglutaminase. The following parameters were analyzed: Sex, age at execution of esophagogastroduodenoscopy, duodenal damage, and number of intraepithelial lymphocytes at biopsies, prevalence ofHelicobacter pyloriinfection, age at execution of colonoscopy, macroscopic and microscopic features of colonoscopy, family history of gastrointestinal and autoimmune diseases, smoking habits, biochemical parameters of inflammation and autoimmunity, use of proton pump inhibitors or nonsteroidal anti-inflammatory drugs, adverse reactions to drugs or foods, pathologies known to be associated with celiac disease or MC, living on a gluten-free diet or on a gluten-low diet for at least 1 mo.
  
  
  RESULTS
  Colonoscopy was performed in 59 patients, but only in 48 of them biopsies were taken in the entire colon. Considering the latter cohort, the diagnosis of MC was met in 25 (52.1%) patients while in 18 patients other pathologic findings were reported: 13 (27%) cases of nonspecific inflammatory bowel disease, 2 (4.2%) cases of Crohn's disease, 2 (4.2%) cases of eosinophilic gastroenteritis, and 1 (2.1%) case of autoimmune enteritis. Five (10.4%) patients had a normal colonoscopic result. Matching the groups by age, and considering only patients who underwent colonoscopy (42.7 ± 15.5 years)vsthose who did not undergo colonoscopy (36.9 ± 10.6 years), a statistical difference was found (P= 0.039). Focusing on symptoms, diarrhea was statistically more prevalent in MC group than in patients who did not undergo colonoscopy (P= 0.03).
  
  
  CONCLUSIONS
  Mild duodenal damage is associated with MC in more than half of the cases. This association supports the hypothesis of a link between these two entities.
authors.affiliation: Gabriele Antonio Bonagura, Davide Giuseppe Ribaldone, Nicoletta Sapone, Giorgio Maria Saracco, Marco Astegiano, Rinaldo Pellicano, Unit of Gastroenterology and Hepatology, Molinette Hospital, 10126 Torino, Italy.
authors.forename: Gabriele Antonio
authors.initials: GA
authors.lastname: Bonagura
authors.affiliation: Gabriele Antonio Bonagura, Davide Giuseppe Ribaldone, Nicoletta Sapone, Giorgio Maria Saracco, Marco Astegiano, Rinaldo Pellicano, Unit of Gastroenterology and Hepatology, Molinette Hospital, 10126 Torino, Italy.
authors.forename: Davide Giuseppe
authors.initials: DG
authors.lastname: Ribaldone
authors.affiliation: Gabriele Antonio Bonagura, Davide Giuseppe Ribaldone, Nicoletta Sapone, Giorgio Maria Saracco, Marco Astegiano, Rinaldo Pellicano, Unit of Gastroenterology and Hepatology, Molinette Hospital, 10126 Torino, Italy.
authors.forename: Sharmila
authors.initials: S
authors.lastname: Fagoonee
authors.affiliation: Gabriele Antonio Bonagura, Davide Giuseppe Ribaldone, Nicoletta Sapone, Giorgio Maria Saracco, Marco Astegiano, Rinaldo Pellicano, Unit of Gastroenterology and Hepatology, Molinette Hospital, 10126 Torino, Italy.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Sapone
authors.affiliation: Gabriele Antonio Bonagura, Davide Giuseppe Ribaldone, Nicoletta Sapone, Giorgio Maria Saracco, Marco Astegiano, Rinaldo Pellicano, Unit of Gastroenterology and Hepatology, Molinette Hospital, 10126 Torino, Italy.
authors.forename: Gian Paolo
authors.initials: GP
authors.lastname: Caviglia
authors.affiliation: Gabriele Antonio Bonagura, Davide Giuseppe Ribaldone, Nicoletta Sapone, Giorgio Maria Saracco, Marco Astegiano, Rinaldo Pellicano, Unit of Gastroenterology and Hepatology, Molinette Hospital, 10126 Torino, Italy.
authors.forename: Giorgio Maria
authors.initials: GM
authors.lastname: Saracco
authors.affiliation: Gabriele Antonio Bonagura, Davide Giuseppe Ribaldone, Nicoletta Sapone, Giorgio Maria Saracco, Marco Astegiano, Rinaldo Pellicano, Unit of Gastroenterology and Hepatology, Molinette Hospital, 10126 Torino, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Astegiano
authors.affiliation: Gabriele Antonio Bonagura, Davide Giuseppe Ribaldone, Nicoletta Sapone, Giorgio Maria Saracco, Marco Astegiano, Rinaldo Pellicano, Unit of Gastroenterology and Hepatology, Molinette Hospital, 10126 Torino, Italy.
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Pellicano
keywords: Autoimmune diseases; Celiac disease; Helicobacter pylori; Intraepithelial lymphocytes; Lymphocytic colitis; Lymphocytic enterocolitis; Microscopic colitis