Histological disease activity in patients with microscopic colitis is not related to clinical disease activity or long-term prognosis

Laerke Müller Olsen, Peter Johan Heiberg Engel, Danny Goudkade, Vincenzo Villanacci, Jeppe Thagaard, Julie Sparholt Walbech, Johan Bohr, Juozas Kupcinskas, Bas Verhaegh, Andreas Münch, Danila Guagnozzi, Fernando Fernández-Bañares, Lars Kristian Munck, Anne-Marie Kanstrup Fiehn

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstract

BACKGROUND: Microscopic colitis (MC) is a common cause of chronic watery diarrhea. Biopsies with characteristic histological features are crucial for establishing the diagnosis. The two main subtypes are collagenous colitis (CC) and lymphocytic colitis (LC) but incomplete forms exist. The disease course remains unpredictable varying from spontaneous remission to a relapsing course.

AIM: To identify possible histological predictors of course of disease.

METHODS: Sixty patients from the European prospective MC registry (PRO-MC Collaboration) were included. Digitised histological slides stained with CD3 and Van Gieson were available for all patients. Total cell density and proportion of CD3 positive lymphocytes in lamina propria and surface epithelium were estimated by automated image analysis, and measurement of the subepithelial collagenous band was performed. Histopathological features were correlated to the number of daily stools and daily watery stools at time of endoscopy and at baseline as well as the clinical disease course (quiescent, achieved remission after treatment, relapsing or chronic active) at 1-year follow-up.

RESULTS: Neither total cell density in lamina propria, proportion of CD3 positive lymphocytes in lamina propria or surface epithelium, or thickness of collagenous band showed significant correlation to the number of daily stools or daily watery stools at any point of time. None of the assessed histological parameters at initial diagnosis were able to predict clinical disease course at 1-year follow-up.

CONCLUSIONS: Our data indicate that the evaluated histological parameters were neither markers of disease activity at the time of diagnosis nor predictors of disease course.

OriginalsprogEngelsk
Sider (fra-til)43-52
Antal sider10
TidsskriftAlimentary Pharmacology and Therapeutics
Vol/bind54
Udgave nummer1
DOI
StatusUdgivet - jul. 2021

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© 2021 John Wiley & Sons Ltd.

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