INFLAMMATION

Lymphocytic colitis: a retrospective clinical study of 199 Swedish patients

M Olesen¹, S Eriksson², J Bohr¹, G Järnerot¹, C Tysk¹

¹ Department of Medicine, Division of Gastroenterology, Örebro University Hospital, Örebro, Sweden
² Department of Pathology, Örebro University Hospital, Örebro, Sweden

Correspondence to:
Correspondence to:
Associate Professor C Tysk
Department of Medicine, Division of Gastroenterology, Örebro University Hospital, 701 85 Örebro, Sweden; curt.tysk{at}orebroll.se

Background: Lymphocytic colitis is characterised by chronic diarrhoea and specific microscopic changes in a macroscopically normal colonic mucosa. We report clinical features and treatment outcome in a large patient cohort.

Methods: Patients were searched for in 24 Swedish gastroenterology clinics. The biopsy material was reassessed using strict histopathological criteria. Clinical data were obtained from medical notes.

Results: Lymphocytic colitis was diagnosed in 199 cases. The female:male ratio was 2.4:1. Median age at diagnosis was 59 (48–70) years. The most frequent symptoms were diarrhoea (96%), abdominal pain (47%), and weight loss (41%). The course was chronic intermittent in 30% of patients, chronic continuous in 7%, and a single attack in 63%, and in these cases the disease duration was 6 (4–11) months. Seventy nine (40%) patients reported associated diseases, of which thyroid disorders, coeliac disease, and diabetes mellitus were the most common. In 34 first or second degree relatives of 24 (12%) patients, a family history of ulcerative colitis, Crohn’s disease, collagenous colitis, or coeliac disease was reported. Drug induced disease was suspected in 19 (10%) patients. A non-significant peak of disease onset was seen in December-January. More than 80% of treated patients improved on corticosteroids, including budesonide.

Conclusions: A family history of other bowel disorders is a new finding. The sudden onset and single attack of limited duration may support a possible infectious cause in some cases. Drugs may cause lymphocytic colitis.

Keywords: autoimmune diseases; coeliac disease; collagenous colitis; inflammatory bowel disease; lymphocytic colitis

Abbreviations: CC, collagenous colitis; IEL, intraepithelial lymphocytes; LC, lymphocytic colitis; MC, microscopic colitis; SeHCAT, selenium homocholic acid taurin

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