Japanese

Microscopic Colitis(Collagenous Colitis, Lymphocytic Colitis): Review and Outline Ichiro Hirata 1 1Department of Gastroenterology, Fujita Health University, Toyoake, Japan Keyword: collagenous colitis , lymphocytic colitis , microscopic colitis , 縦走潰瘍ランソプラゾール pp.1947-1953
Published Date 2009/12/25
DOI https://doi.org/10.11477/mf.1403101812
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 CC(collagenous colitis)and LC(lymphocytic colitis)are generally diseases that have affinity with each often and are usually called MC(microscopic colitis). The incidence rate of MC is 8.6~10.0(CC 3.1~4.9,LC 4.4~5.5)/100,000 populations-years. The median age at diagnosis of MC is 65~68 years old and the male : female sex ratio is 1:7 in CC and 1:24 in LC. Female is preponderant in CC, but LC does not have this tendency. Autoimmune disease, bile acid metabolic disorders, enteric infection, and medication are named as causes of MC, but no conclusive evidence obtained. The patients of MC as compared with has not been controls frequently have the autoantibody(antinuclear antibody, anti-gliadin antibody,ASCA), and merger with some autoimmune disease is reported. As medicine associated with MC NSAIDs,PPI(Lansoprazole ; LPZ in particular),SSRI,H2-blocker, ticlopidine and aspirin are given, but medication arrived at by a case-controlled study is NSAIDs and SSRI.

 The abnormal vascular pattern, redness, edema, a granular change, a longitudinal ulcer in the large intestinal mucosa are listed as endoscopic findings of MC. Some kind of endoscopic abnormality is found in approximately 30% of MC(more than 75% in this country). Granular mucosal change and CB(collagen band)deposition are frequently found in the right colon. A longitudinal ulcer in CC often appears it as a very long linear ulcer(or ulcer scar), and it is characteristic that ulcer periphery mucosa does not show inflammatory change. The association of longitudinal ulcer with LPZ is reported, and there is a report to show that 78% of LPZ users have longitudinal ulcer particularly in this country. Such a high frequency is not shown in Europe and America, and there is a report that suggested an association of NSAID and the longitudinal ulcer. This longitudinal ulcer frequently occurs in the transverse colon to the right colon in Europe and America, but frequently occurs in the left colon in this country.

 As diseases that need differentiation from CC, there are ischemic colitis,Crohn's disease, intestinal amyloidosis, idiopathic mesenteric phlebosclerosis, irritable bowel syndrome, infectious enteritis and celiac disease. Budesonide is effective for its treatment, and the prognosis of MC is generally good.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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