A team from the Cleveland Clinic Foundation, Ohio, USA, determined the prevalence of celiac disease in microscopic colitis (collagenous and lymphocytic colitis).
Patients were identified from a pathology registry of microscopic colitis from 1987 to 1999. Pathology reports and medical records were reviewed for previous small bowel biopsies and/or celiac serology.
The researchers identified 113 patients with microscopic colitis.
|15% of patients with lymphocytic colitis also had celiac disease.
|J Clin Gastroenterol |
46 patients underwent a small bowel biopsy and/or celiac serology.
Of these, 27 patients had lymphocytic colitis (63% female; mean age, 58.6 years) and 19 patients had collagenous colitis (79% female; mean age, 61.8 years).
Small bowel biopsy alone was performed in 28 of 46 patients; celiac serology alone was performed in 10; and both small bowel biopsy and celiac serology were performed in 8.
Celiac disease was identified in 4 patients by small bowel histology; all had lymphocytic colitis (4 of 27 patients, 15%).
This frequency of celiac disease was significantly higher than the highest reported US prevalence of celiac disease (4 per 1,000 individuals).
There was also a high frequency of celiac disease in patients with lymphocytic colitis.
Researcher Christi A Matteoni concluded on behalf of the group, "Given the importance of the early detection of celiac disease, the diagnosis should be excluded in all patients with lymphocytic colitis, particularly if diarrhea does not respond to conventional treatment."