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At least 19 recordsLinked to original sources
PubMed1991

[HLA-DR antigen expression on colonic epithelium of ulcerative colitis in comparison with infectious colitis and ischemic colitis].

We examined HLA-DR antigen expression on endoscopically biopsied colonic epithelium of ulcerative colitis (UC), infectious colitis and ischemic colitis. Since this monoclonal antibody (LN-3 ICN Immunobiological, USA) is available for usual formalin fixated materials, if the fixation is limited within 36 hours. 886 samples from 55 UC cases, 91 samples from 19 infectious colitis cases, 63 samples from 15 ischemic colitis cases and 63 samples from normal cases were enough statistically, compared to DR antigen expression. UC expressed clearly statistical high positive DR staining rate than infections colitis and ischemic colitis. Further, samples from UC and infectious colitis were compared in the histopathologically each with the same grade of inflammation, UC expressed higher positive rates of DR antigen than infectious colitis, and both UC and infectious colitis showed increased positive rates of DR antigen with advance of histopathological grades of inflammation.

Bacterial Infections↗
PubMed1991

Newly recognized forms of colitis: collagenous colitis, microscopic (lymphocytic) colitis, and lymphoid follicular proctitis.

Based on pertinent data from the literature and on their personal experience, the authors present a clinicopathological review of collagenous colitis, microscopic (lymphocytic) colitis, and lymphoid follicular proctitis. The following aspects of these three newly recognized forms of colitis are emphasized: clinical features, light microscopy, histological diagnostic problems, immunological aspects, coexisting diseases, treatment, etiology, and pathogenesis. Special attention is paid to possible overlap between collagenous colitis and microscopic (lymphocytic) colitis.

Adult↗
PubMed1979

Colitis in the elderly: ischemic colitis mimicking ulcerative and granulomatous colitis.

Eight patients over age 60 years had sudden onset of acute abdominal pain and rectal bleeding in the absence of prior inflammatory bowel disease. Several improved on medical therapy alone; those who required surgery suffered no recurrence up to 6 years. Although the pathologic specimens on these patients were first considered to represent ulcerative colitis or Crohn's disease, their histories and clinical courses are much more consistent with ischemic colitis. Since there are only a limited number of reactions that the bowel can muster against a host of damaging processes, histologic criteria alone are usually not sufficient to separate ischemic disease of the colon from ulcerative colitis and Crohn's disease. This is also true of radiographic features. Thus the diagnosis of ischemic colitis rests on clinical onset and course after treatment.

Aged↗
PubMed1975

Inflammatory disease of the colon: ulcerative colitis and Crohn's colitis.

Ulcerative colitis differs from Crohn's colitis in several ways. In ulcerative colitis the disease is limited to the mucosa and, occasionally, the submucosa; Crohn's colitis may involve all layers of the large intestine. Ulcerative colitis almost always begins in the rectum, is diffuse, and spreads proximally. Crohn's colitis may spare the rectum and has a patchy distribution. Perianal fistulas and ulcers are rare in ulcerative colitis but are common in Crohn's colitis. Granulomas and giant cells are not found in ulcerative colitis but are seen in the majority of patients with Crohn's colitis. Colonic and extraintestinal symptoms in the two illnesses may be indistinguishable but growth failure is far more severe in Crohn's colitis and may precede intestinal symptoms by months to years. Cancer of the colon is a risk in patients with either ulcerative or Crohn's colitis but is far more common in the former. It is important to distinguish between ulcerative colitis and Crohn's colitis because response to treatment and prognosis are different. Although neither condition can be cured by medical management, patients with ulcerative colitis may respond more frequently. Unfortunately, in the pediatric age range most cases of ulcerative and Crohn's colitis may be classified as moderate to severe. Fortunately for patients with ulcerative colitis, total colectomy with ileostomy will result in cure of illness. Patients with Crohn's colitis who require surgery may obtain remission of symptoms, but the disease is likely to recur in the small intestine.

Adrenal Cortex Hormones↗
PubMed1992

Increased HLA A1 and diminished HLA A3 in lymphocytic colitis compared to controls and patients with collagenous colitis.

Lymphocytic colitis is a newly described chronic diarrheal disorder. Although its etiology is unknown, the possibility has been raised that autoimmunity may play a role in both lymphocytic and collagenous colitis, a similar clinicopathologic illness. The frequencies of HLA class I and class II antigens were examined in 24 white patients with lymphocytic colitis and in 47 white patients with collagenous colitis. Frequencies in these two disorders were compared to control white populations and to each other. An increased frequency of HLA-A1 was noted in 16 of 24 lymphocytic colitis patients (66.6%) compared with 1089 of 3942 controls (27.6%) (P less than 0.005; relative risk 5.2). Furthermore, HLA-A3 was found in decreased frequency in lymphocytic colitis patients: 0 of 24 (0%) compared with 1017 of 3942 controls (25.8%) (P less than 0.05; relative risk 0.0). Collagenous colitis patients had no significant deviation from control frequencies of HLA antigens. In lymphocytic colitis, there was no significant increase in B8 or DR3 antigens, which are found in linkage disequilibrium with A1 and associated with many autoimmune diseases. Moreover, the frequency of autoimmune-associated class I HLA antigens was not increased in lymphocytic colitis. Statistically significant differences existed between lymphocytic and collagenous colitis in HLA-A1, A3, Bw6, and B7 antigen frequencies. The HLA patterns noted previously in other gastrointestinal disorders, including ulcerative colitis and Crohn's disease, were not apparent in lymphocytic or collagenous colitis. HLA typing provides further evidence that lymphocytic colitis is a distinct form of chronic intestinal inflammatory disease associated with HLA class I phenotypes.

Colitis↗
PubMed1976

Ulcerative colitis or Crohn's colitis. Is differentiation necessary?

Three types of colitis are now recognized. In the late 1950's and early 1960's, 51 per cent of our patients having colectomy had classic chronic ulcerative colitis. Of our patients operated on at that time, 39 per cent had Crohn's colitis and 10 per cent had colitis of indeterminate type. These three types of colitis should be differentiated because of the high risk of cancer of the colon in patients with long-standing chronic ulcerative colitis. We have not seen an increased risk of carcinoma associated with Crohn's colitis. We performed resection with anastomosis in approximately one third of patients with Crohn's colitis, but recurrent disease developed in two thirds. In contrast, recurrent Crohn's disease developed in only 5.7 per cent of patients having colectomy with ileostomy. Toxic megacolon associated with Crohn's colitis has been seen only in the early clinical stage of the disease. From the standpoint of management and prognosis, attempts to differentiate between the two major types of colitis are appropriate. We have outlined some of the basic clinical and pathologic differences between these two types of colitis.

Anus Diseases↗
PubMed1991

Colorectal cancer in ulcerative colitis. Influence of anatomical extent and age at onset on colitis-cancer interval.

We have examined the age at onset of both ulcerative colitis and colitis-associated colorectal cancer in 100 patients seen at Mount Sinai Hospital between 1959 and 1988. There were 85 patients with extensive colitis and 15 with left sided colitis. There was a strong direct correlation between the age at onset of ulcerative colitis and age at diagnosis of cancer (p less than 0.0001); this correlation was found both in patients with extensive colitis (p less than 0.0001) and in those with left sided colitis (p less than 0.005). Patients with left sided colitis developed both their colitis and their cancers about a decade later than did those with extensive disease, but the mean duration of colitis before diagnosis of cancer was virtually the same (about 21 years) in both groups, irrespective of the age at onset of disease.

Adult↗
PubMed1992

Acetic acid-induced colitis in the rat: a reproducible experimental model for acute ulcerative colitis.

There exists no ideal model for experimental ulcerative colitis in common laboratory animals. Therefore, we tried in the present study to establish a reproducible model for inducing colitis in rats by using acetic acid. A blind loop of the colon including the cecum, ascending colon and part of the transverse colon, was brought out through two colostomies. After mechanical washing with warm normal saline, acetic acid was instilled at different doses (4, 6 and 8%) for different exposure times (10, 15, 20, 25 and 30 s). The excluded colon was examined by light microscopy on the 1st, 2nd, 3rd, 4th, 7th and 14th days after operation and acetic acid instillation. We found that 4% acetic acid for 15 s produced a moderate, superficial colitis on the 1st day after operation, whereafter a uniform colitis evolved in all rats on the 4th day after operation. The developed colitis showed morphological similarities with human ulcerative colitis. Signs of healing and regeneration of the mucosa were seen on the 7th day, and the mucosa became almost normal at the 14th day after operation. 6 or 8% acetic acid solution or exposure times exceeding 15 s resulted in severe, deep colitis with a concomitant high mortality rate. In contrast, at exposure times less than 15 s, acetic acid induced only mild superficial colitis. We conclude that by using 4% acetic acid for 15 s in the excluded colon a uniform and reproducible colitis pathologically resembling human ulcerative colitis could be achieved. Furthermore, no mortality was encountered and the general health of the rats was similar to that of the controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetates↗
PubMed1992

["Spontaneous" ischemic colitis: infectious or medicamentous colitis? 25 cases].

The diagnosis of non-gangrenous ischaemic colitis is difficult to assert when histological findings are not specific and when no precipitating cardiovascular event can be found. The constant absence of relapse after the initial episode suggests that an extraneous triggering event is involved. We have studied retrospectively 25 cases of spontaneous ischaemic colitis, looking for a non-haemodynamic triggering event. At the onset of colitis 9 patients had been taking non-steroidal anti-inflammatory drugs or antibiotics for 2 weeks or less. In 3 other patients colitis was associated with Escherichia coli O157:H7 infection. Striking clinical, endoscopic and histological similarities exist between ischaemic colitis on the one hand and colitis caused by absorption of non-steroidal anti-inflammatory drugs or ampicillin and the colitis reported in E. coli O157:H7 infection on the other hand. Non-steroidal anti-inflammatory drugs and E. coli O157:H7 intestinal infection, possibly facilitated by an antibiotic treatment with e.g. ampicillin, could be either non-haemodynamic triggering factors for ischaemic colitis, or responsible per se for a transient acute colitis with the same characteristics as ischaemic colitis.

Adult↗
PubMed1992

Ulcerative colitis-linked antineutrophil cytoplasmic antibody in the cotton-top tamarin model of colitis.

The presence of antineutrophil cytoplasmic antibodies (ANCA) in serum has recently been shown to be a good disease marker for ulcerative colitis. An animal model of colitis expressing serum ANCA would allow prospective studies of the relationship between ANCA expression and development of colitis. The cotton-top tamarin model of spontaneous colitis was investigated for presence of ANCA to evaluate its potential as a model for the study of the immune response in human ulcerative colitis. Results show that cotton-top tamarin neutrophils have antigens recognized by immunoglobulin G (IgG) from the ANCA-positive serum of patients with ulcerative colitis. However, cotton-top tamarins do not generate serum IgG reactive to cotton-top tamarin or human neutrophils even when equal amounts of IgG are used for antigen detection. As new animal models of spontaneous and induced chronic colitis are developed, the presence of ANCA in serum, using the species' neutrophils, will be useful in relating the immune response of the model to that in human ulcerative colitis.

Animals↗
PubMed1975

Sequelae of colectomy and ileostomy: comparison between Crohn's colitis and ulcerative colitis.

A comparison is made of the immediate and long term mortality of colectomy and ileostomy between 73 patients who had Crohn's colitis and 442 who had ulcerative colitis. The immediate mortality in Crohn's disease is 4%. In ulcerative colitis it is 10%, chiefly because of the higher proportion of emergency operations. The late mortality in both groups is 10%, chiefly as a result of recurrence of Crohn's disease or the sequellae of colonic malignancy present at the time of colectomy for ulcerative colitis. A further comparison is made between the postoperative course of the 64 surviving patients with Crohn's disease and a comparable sample of 65 patients who had an ileostomy for ulcerative colitis in the same era. There was a similar incidence of postoperative septic complications in the two groups (35%). The readmission rate was twice as high in the Crohn's disease patients. Ileostomy reconstruction for mechanical complication was needed in 21 patients with Crohn's disease compared with 6 with ulcerative colitis. Further ileal resection was required for recurrent disease on another 25 occasions in the patients with Crohn's disease but never in those with ulcerative colitis. Long therm review graded the clinical status as excellent or good in 70% of those with Crohn's disease compared with 95% with ulcerative colitis.

Adult↗
PubMed1992

Subepithelial collagen table thickness in colon specimens from patients with microscopic colitis and collagenous colitis.

Microscopic colitis and collagenous colitis are similar conditions that are differentiated by the presence or absence of subepithelial collagen table thickening. To better understand the relationship between these two disorders and the role of collagen table thickening in the pathogenesis of diarrhea, colonic mucosal biopsy specimens from 24 patients with microscopic or collagenous colitis and 9 control subjects were analyzed using a computer-assisted morphometric method to evaluate the average thickness of the subepithelial collagen table. The collagen table thickness in colitis patients taken together formed a multimodal rather than a unimodal distribution. There was no tendency for collagen table thickening to increase with age or with duration of symptoms. In general, the types and distribution of inflammatory cells were similar in patients with normal and thickened collagen tables. Stool weight correlated with lamina propria cellularity but not with collagen table thickening. The multimodal distribution of collagen table thickening and the lack of correlation with age, duration of symptoms, or inflammation suggest that microscopic colitis and collagenous colitis are discrete conditions, although the inflammatory changes in the two conditions are similar. Moreover, because stool weight correlates with lamina propria cellularity but not with collagen table thickening, diarrhea probably is caused by the inflammatory changes and not by collagen table thickening per se.

Adult↗
PubMed1975

[Immunopathology of ulcerative colitis and granulomatous colitis (author's transl)].

There is no convincing evidence as yet for a key role of immunological processes in the pathogenesis of unspecific colitis. However clinical findings as well as immunological data do support the hypothesis that immune reactions are involved primarily or secondarily in the pathogenesis and the clinical course of ulcerative colitis and granulomatous colitis. In such patients a specific adaptation of humoral and cell-bound immune reactions against antigenic material from the colon and other tissues has been found in peripheral blood, lymphatic tissue and bowel wall. In this context it seems to be especially noteworthy, that lymphocytes taken from patients with colitis lead to disintegration of colon epithelial cells in vitro. This cytotoxic effect of the lymphocytes is lost after colectomy or remission of the disease. Ulcerative and granulomatous colitis do have many clinical and immunological peculiarities in common. This makes one think, that possibly the same noxious factors induce differential local reactions because of different hereditary disposition.

Antigen-Antibody Complex↗
PubMed1992

[Microscopic colitis and collagenous colitis. An entity not yet reported in Chile].

Collagenous and microscopic colitis have been described as causes for abundant watery diarrhea with a normal radiologic and endoscopic aspect of the colonic mucosa. Microscopic colitis is characterized by diffuse intraepithelial lymphocytic infiltration and collagenous colitis by thickening of subepithelial collagen layer greater than 15 microns with or without inflammatory changes of the mucosa. Here are reported 5 patients with microscopic colitis and 4 with collagenous colitis. The mean age was 52 years (range 40 to 68) with an equal sex distribution. Diarrhea was of longstanding duration without weight loss, anemia or hypoalbuminemia. Occasionally the volume of diarrhea was over 1 L a day. One patient had steatorrhea that proved resistant to a gluten free diet. Endoscopic and radiologic findings were normal in every patient and the diagnosis was based on typical histology. Azulfidine therapy was successful in 7 patients and prednisone in another. Colonic biopsy should be performed in every patient with chronic diarrhea.

Adult↗
PubMed1975

The pseudomembranous colitis associated with clindamycin therapy--a viral colitis.

Four patients are described who developed pseudomembranous colitis in association with clindamycin therapy. Rectal biopsies from two patients were studied with the electron microscope and compared with the ultrastructural appearance of the rectal mucosa from seven normal people. Ultrastructural evidence for a viral colitis was obtained. The significance of the clindamycin therapy to the viral colitis and the contribution of the viral colitis to the clinical state are discussed.

Adult↗
PubMed1977

Immunological studies in ulcerative colitis. VIII. Antibodies to colon antigen in patients with ulcerative colitis, Crohn's disease, and other diseases.

Sera from patients with ulcerative colitis or Crohn's disease had elevated titers to colon antigen from germ-free rats significantly more often than sera from patients with gastroenteritis, irritable colon, non-gastrointestinal diseases, and healthy controls. Elevated anticolon titers in significant frequency were also found in patients with liver cirrhosis, urinary tract infections, and in polyposis coli and their relatives. Females with ulcerative colitis had, on an average, higher titers than men especially in the age group 30 years and over. In Crohn's disease the antibody titers often increased with time--as opposed to those in ulcerative colitis and non-gastrointestinal diseases. In conjunction with results published earlier, the present work supports the assumption that the antibodies in ulcerative colitis patients react with antigenic determinants distinct from those recognized by the colon antibodies present in other groups, including patients with Crohn's disease and polyposis.

Adolescent↗
PubMed1991

Crohn's colitis complicated by superimposed invasive amebic colitis.

The clinical characteristics and endoscopic appearance of inflammatory bowel disease (IBD) may be very similar to those of amebic colitis. Physicians, especially in areas in which amebiasis is endemic, are familiar with this difficulty. Moreover, in individual cases, it may even be impossible to distinguish between the two conditions, since stool specimens, bowel biopsies, and serological studies may be negative for Entamoeba histolytica, even in the presence of invasive amebic colitis. Invasive amebiasis may rarely be superimposed on IBD, which further complicates the issue. We report here a young patient with a 7-yr history of Crohn's colitis proven histologically who developed invasive amebic colitis during steroid and 6-mercaptopurine treatment for active disease. Stool specimens, mucosal biopsies, and serological studies were negative for E. histolytica, and the diagnosis was established on pathological examination of a surgically resected bowel. Anti-amebic therapy should be considered in endemic areas in cases of persistent IBD.

Adult↗