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Clinicopathologic Characterization of Lymphocytic Colitis in the Pediatric Population.
- Source :
- Pediatric & Developmental Pathology; Mar2024, Vol. 27 Issue 2, p156-168, 13p
- Publication Year :
- 2024
-
Abstract
- Background: Lymphocytic colitis (LC) in the pediatric population has been associated with immune dysregulation. Methods: Single-center retrospective study of pediatric LC. Results: 50 patients (35 female, 70%) with a median age of 12 years at diagnosis (interquartile range: 5.7–15.8) of LC were identified. At presentation, 11 patients (22%) had malnutrition, 16 (32%) had a known underlying immune dysregulation, 4 (8%) had celiac disease (CD), and none had a diagnosis of inflammatory bowel disease. The most common medications prior to diagnosis were non-steroidal anti-inflammatory drugs, proton pump inhibitor, and selective serotonin reuptake inhibitors (10% each). Colonic biopsies showed a median number of intraepithelial lymphocytes (IELs)/100 epithelial cells of 48 (range: 25–85), and only 10% of cases had neutrophilic cryptitis. Upper gastrointestinal tract findings included lymphocytic esophagitis (4%), and duodenal IELs without and with villous blunting (9% each) (n: 47). Ten patients (23%) had increased IELs in the terminal ileum (n: 43). Treatments including 5-ASA, budesonide, prednisone, and gluten-free diet improved symptoms in <50% of patients (n: 42), and all follow-up colonoscopies showed persistent LC (n: 13). Conclusion: Our study supports the association of LC with immune-mediated conditions, most commonly celiac disease. Symptomatic improvement was seen in <50% of patients with none of the patients with repeat colonoscopy showing histologic improvement. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 10935266
- Volume :
- 27
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Pediatric & Developmental Pathology
- Publication Type :
- Academic Journal
- Accession number :
- 176581984
- Full Text :
- https://doi.org/10.1177/10935266231215117