ORIGINAL RESEARCH
Gastroenterology
doi: 10.25005/2074-0581-2026-28-1-22-28
CLINICAL AND PATHOMORPHOLOGICAL CHARACTERISTICS OF PATIENTS WITH MICROSCOPIC COLITIS: A RETROSPECTIVE STUDY

R.R. SAVZIKHANOVA1, D.G. ISKHAKOVA2, E.V. KHAZOVA1, YU.A. KAZYKHANOVA2, N.A. DANILOVA2, R.N. KULAGIN2

1Department of Propaedeutics of Internal Diseases named after Professor S.S. Zimnitsky, Kazan State Medical University, Kazan, Russian Federation
2Department of Gastroenterology, City Clinical Hospital No. 7 named after M.N. Sadykov, Kazan, Russian Federation

Objective: To analyze the clinical and histological data of patients with microscopic colitis (MC).

Methods: A retrospective analysis was performed of risk factors and the clinical and morphological features of MC (n=47), including analyses by patient sex and MC subtypes: collagenous and lymphocytic. Quantitative variables are presented as median and interquartile range; categorical variables are presented as absolute counts and proportions. Between-group differences in categorical variables were assessed using Pearson’s χ² test. Statistical analysis was performed in Jamovi.

Results: The duration of MC before diagnostic verification was 14 [9; 19] months, with disease onset at age 42 [34; 62] years. According to biopsy findings, the collagenous type of MC was identified in 75% of patients, and the lymphocytic type in 25%. MC is more frequently diagnosed in women, and in ¾ of cases it is of the collagenous type. Collagenous colitis is more often diagnosed in patients aged 45-59 years and is characterized by diarrhea (p<0.001), false urges to defecate (p=0.015), and concomitant allergy (p=0.045). In lymphocytic colitis, diarrhea alternating with constipation (p=0.002), as well as nausea (p=0.023) and weakness (p=0.020), are more common. Patients with lymphocytic colitis are more likely to have concomitant anemia (OR=7.5; 95% CI: 1.25-44.9), celiac disease (OR=11.3; 95% CI: 1.13-112), and vitamin B12 deficiency (OR=18.2; 95% CI: 0.876-378). In stool analysis, patients with collagenous colitis more often show indigestible (p=0.045) and digestible plant fibers (p>0.05); in lymphocytic colitis, unchanged muscle fibers are more common (p=0.048).

Conclusion: In cases of prolonged watery diarrhea, MC should be ruled out regardless of patient age, with increased vigilance in women. Given the frequent coexistence of MC and celiac disease, celiac screening appears advisable.

Keywords: Microscopic colitis, collagenous colitis, lymphocytic colitis, diagnosis, risk factors.

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References
  1. Nielsen OH, Fernandez-Banares F, Sato T, Pardi DS. Microscopic colitis: Etiopathology, diagnosis, and rational management. Elife. 2022;11:e79397. https://doi.org/10.7554/eLife.79397
  2. Miehlke S, Guagnozzi D, Zabana Y, Tontini GE, Kanstrup Fiehn AM, Wildt S, et al. European guidelines on microscopic colitis: United European Gastroenterology (UEG) and European Microscopic Colitis Group (EMCG) statements and recommendations. United Eur Gastroenterol J. 2021;9:13-37. https://doi. org/10.1177/2050640620951905
  3. Lophaven SN, Lynge E, Burisch J. The incidence of inflammatory bowel disease in Denmark 1980-2013: A nationwide cohort study. Aliment Pharmacol Ther. 2017;45(7):961-72. https://doi.org/10.1111/apt.13971
  4. Freeman HJ. Collagenous colitis associated with novel sprue-like intestinal diseases. Gastroenterol Hepatol Bed Bench. 2023;16(2):145-50. https://doi. org/10.22037/ghfbb.v16i2.2698
  5. Langner C, Aust D, Ensari A, Villanacci V, Becheanu G, Miehlke S, et al; Working Group of Digestive Diseases of the European Society of Pathology (ESP) and the European Microscopic Colitis Group (EMCG). Histology of microscopic colitis-review with a practical approach for pathologists. Histopathology. 2015;66(5):613-26. https://doi.org/10.1111/his.12592
  6. Fiehn AK, Engel PJH, Engel U, Jepsen DNM, Blixt T, Rasmussen J, et al. Number of intraepithelial lymphocytes and presence of a subepithelial band in normal colonic mucosa differs according to stainings and evaluation method. J Pathol Inform. 2024;15:100374. https://doi.org/10.1016/j.jpi.2024.100374
  7. Verhaegh BP, Jonkers DM, Driessen A, Zeegers MP, Keszthelyi D, Masclee AA, et al. Incidence of microscopic colitis in the Netherlands. A nationwide population- based study from 2000 to 2012. Dig Liver Dis. 2015;47(1):30-6. https://doi. org/10.1016/j.dld.2014.09.019
  8. Fernández-Bañares F, Zabana Y, Aceituno M, Ruiz L, Salas A, Esteve M. Prevalence and natural history of microscopic colitis: A population-based study with long- term clinical follow-up in Terrassa, Spain. J Crohns Colitis. 2016;10(7):805-11. https://doi.org/10.1093/ecco-jcc/jjw037
  9. Vigren L, Olesen M, Benoni C, Sjöberg K. An epidemiological study of collagenous colitis in southern Sweden from 2001-2010. World J Gastroenterol. 2012;18(22):2821-6. https://doi.org/10.3748/wjg.v18.i22.2821
  10. Münch A, Langner C. Microscopic colitis: Clinical and pathologic perspectives. Clin Gastroenterol Hepatol. 2015;13(2):228-36. https://doi.org/10.1016/j. cgh.2013.12.026
  11. Raju SA, Rawcliffe ME, Bowker-Howell FJ, Shiha MG, Kaur KE, Griffin J, et al. Coeliac disease and microscopic colitis: The largest study assessing prognosis and risk of hospital admission. Nutrients. 2024;16(13):2081. https://doi. org/10.3390/nu16132081
  12. Roth B, Ohlsson B. Microscopic colitis found together with celiac disease in a female population is associated with one episode of lymphocytic colitis. BMC Gastroenterol. 2024;24(1):70. https://doi.org/10.1186/s12876-024-03158-2
  13. Burke KE, D'Amato M, Ng SC, Pardi DS, Ludvigsson JF, Khalili H. Microscopic colitis. Nat Rev Dis Primers. 2021;7(1):39. https://doi.org/10.1038/s41572-021-00273-2
  14. Nimri FM, Muhanna A, Almomani Z, Khazaaleh S, Alomari M, Almomani L, et al. The association between microscopic colitis and celiac disease; A systematic review and meta-analysis. Ann Gastroenterol. 2022;35:281-9. https://doi. org/10.20524/aog.2022.0714
  15. Malik A, Goyal H, Adler DG, Javaid S, Malik MI, Singh S, et al. Budesonide versus Mesalamine in microscopic colitis: A comparative meta-analysis of randomized controlled trials. J Clin Gastroenterol. 2025;59(7):629-39. https:// doi.org/10.1097/MCG.0000000000002025

Authors' information:

Savzikhanova Renata Rashidovna,
Graduate Student, Kazan State Medical University
Researcher ID: LZG-6231-2025
ORCID ID: 0009-0008-5906-7476
SPIN: 1658-9382
E-mail: renatasavzihanova@mail.ru

Iskhakova Dilyara Gabdrashidovna,
Head of the Department of Gastroenterology, City Clinical Hospital No. 7 named after M.N. Sadykov
Scopus ID: 58193812700
ORCID ID: 0000-0003-3829-5302
SPIN: 9327-3103
Author ID: 1258696
E-mail: iskhakova_d@mail.ru

Khazova Elena Vladimirovna,
Doctor of Medical Sciences, Associate Professor of the Department of Propaedeutics of Internal Diseases named after professor SS. Zimnitsky, Kazan State Medical University
Researcher ID: O-2336-2016
Scopus ID: 57205153574
ORCID ID: 0000-0001-8050-2892
SPIN: 7013-4320
Author ID: 639552
E-mail: hazova_elena@mail.ru

Kazykhanova Yulduz Aidarovna,
Gastroenterologist, Department of Gastroenterology, City Clinical Hospital No. 7 named after M.N. Sadykov
ORCID ID: 0009-0009-6857-0417
E-mail: blood94363@list.ru

Danilova Natalya Aleksandrovna,
Candidate of Medical Sciences, Gastroenterologist, Department of Gastroenterology, City Clinical Hospital No. 7 named after M.N. Sadykov
Scopus ID: 57209208232
ORCID ID: 0000-0002-7137-5032
SPIN: 8402-9327
Author ID: 1018409
Researcher ID: B-8168-2019
E-mail: danilova.natalya.87@mail.ru

Kulagin Roman Nikolaevich,
Candidate of Medical Sciences, Associate Professor, Pathologist, City Clinical Hospital No. 7 named after M.N. Sadykov
ORCID ID: 0009-0002-8182-1486
SPIN: 4615-2523
Author ID: 178067
Email: rnkulagin@yandex.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Khazova Elena Vladimirovna
Doctor of Medical Sciences, Associate Professor of the Department of Propae- deutics of Internal Diseases named after professor SS. Zimnitsky, Kazan State Medical University

420012, Russian Federation, Kazan, Butlerov str., 49

Tel.: +7 (905) 3139710

E-mail: hazova_elena@mail.ru


This work is licensed under a Creative Commons Attribution 4.0 International License.

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