Associations of Microscopic Colitis With Other Lymphocytic Disorders of the Gastrointestinal Tract.
BACKGROUND & AIMS
Lymphocytic disorders of the upper and lower gastrointestinal tract seem to cluster in patients. We aimed to assess the frequency of comorbid occurrence of lymphocytic disorders in patients with microscopic colitis (MC).


METHODS
We collected data from the Miraca Life Sciences Database, a large national electronic repository of histopathologic records of patients throughout the United States. In a population of 228,506 patients who underwent bidirectional endoscopy from January 2008 through July 2016, we studied the comorbid occurrence of celiac disease, duodenal intraepithelial lymphocytosis, lymphocytic gastritis, and lymphocytic esophagitis among 3456 patients with MC. Associations were described in terms of their odds ratios (OR) and 95% CIs.


RESULTS
Any type of lymphocytic disorder occurred in 13.7% of patients with MC and 5.9% of patients without MC. The ORs of lymphocytic disorders in patients with MC were: 2.56 (95% CI, 2.32-2.82) for any type of lymphocytic disorder, 3.07 (95% CI, 1.25-7.52) for lymphocytic esophagitis, 15.05 (95% CI, 12.31-18.41) for lymphocytic gastritis, 1.73 (95% CI, 1.53-21.96) for duodenal intraepithelial lymphocytosis, and 6.06 (95% CI, 5.06-7.25) for celiac disease. Comorbidities were more common in patients with lymphocytic than collagenous colitis, with an OR of 1.74 (95% CI, 1.42-2.13). Patients with MC with comorbidities were significantly younger and had a lower proportion of men than patients with MC patients without comorbidities. Diarrhea was the predominant symptoms in all patients MC, irrespective of comorbidities.


CONCLUSION
In a retrospective study, we identified lymphocytic disorders of the upper gastrointestinal tract that are significantly more common in patients with than without MC. These associations suggest the existence of an underlying etiology that is common to all lymphocytic disorders and that affects the upper and lower gastrointestinal tract.
['Sonnenberg|Amnon|A|', 'Turner|Kevin O|KO|', 'Genta|Robert M|RM|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D002446:Celiac Disease D046728:Colitis, Microscopic D015897:Comorbidity D004382:Duodenitis D004941:Esophagitis D005260:Female D005756:Gastritis D041981:Gastrointestinal Tract D006801:Humans D008297:Male D008875:Middle Aged D052016:Mucositis D012189:Retrospective Studies D014481:United States
Environmental Risk Factors Epidemiology Helicobacter pylori Infection Immune Response