Journal of Mahatma Gandhi University of Medical Sciences and Technology

Register      Login

VOLUME 3 , ISSUE 3 ( September-December, 2018 ) > List of Articles

CASE REPORT

Microscopic Colitis Presenting as Difficult Diarrhea in a Patient of Rheumatoid Arthritis

Chhavi Goyal, Manish Pahadia

Keywords : Antinuclear antibody, Collagenous colitis, Irritable bowel syndrome, Lymphocytic colitis, Metacarpophalangeal (joint)/proximal interphalangeal (joint), Microscopic colitis, Small intestine

Citation Information : Goyal C, Pahadia M. Microscopic Colitis Presenting as Difficult Diarrhea in a Patient of Rheumatoid Arthritis. J Mahatma Gandhi Univ Med Sci Tech 2018; 3 (3):93-96.

DOI: 10.5005/jp-journals-10057-0086

License: CC BY-NC 4.0

Published Online: 21-07-2020

Copyright Statement:  Copyright © 2018; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Microscopic colitis is an uncommon intestinal disorder that presents with chronic diarrhea. It is treatable, but its diagnosis may often prove difficult specifically in developing countries as it requires a GI endoscopy unit and since its incidence is on rise now it needs a high index of suspicion followed by colonic biopsy for diagnosis. It is a condition diagnosed when a patient with chronic watery nonbloody diarrhea has an endoscopically or radiographically normal colon, but colonic mucosal biopsies show unique inflammatory changes; because the mucosa is not otherwise disrupted or ulcerated, diarrhea does not contain blood or pus. We present the case of a 53-year-old woman with pathogen-negative chronic diarrhea who is a k/c/o rheumatoid arthritis (RA) since past 12 years and hypothyroidism since past 5 years. She responded well to treatment of low-dose steroids after colonoscopy and colonic biopsy successfully hinted her illness. Conclusion: Patients with pathogen-negative chronic diarrhea having h/o multiple drugs intake or autoimmune diseases not responding to usual treatment should be subjected to a colonoscopy followed by biopsy to diagnose microscopic colitis.


PDF Share
  1. Schiller LR. Chronic diarrhea. Gastroenterology 2004;127(1):287–293. DOI: 10.1053/j.gastro.2004.05.028.
  2. Riddel RH, Tanka M, Mazzoleni G. Non-steroidal anti-inflammatory drugs as a possible cause of collagenous colitis: a case-control study. Gut 1992;33(5):683–686. DOI: 10.1136/gut.33.5.683.
  3. Mahajan D, Goldblum JR, Xiao SY, et al. Lymphocytic colitis and collagenous colitis: a review of clinicopathologic features and immunologic abnormalities. Adv Anat Pathol 2012;19(1):28–38. DOI: 10.1097/PAP.0b013e31823d7705.
  4. Otegbayo JA, Oluwasola A, Akang EE. Collagenous colitis in an adult patient with chronic diarrhea: case report. East Afr Med J 2001;78(5):272–274. DOI: 10.4314/eamj.v78i5.9054.
  5. Read NW, Kreis GJ, Read MG. Chronic diarrhoea of unknown origin. Gastroenterology 1980;78(2):264–271. DOI: 10.1016/0016-5085(80)90575-2.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.