Abstract
BACKGROUND: The aetiology and pathogenesis of collagenous colitis are unknown. Autoimmunity has been suggested, but no serological findings have supported such a theory. AIMS AND METHODS: Serum from 38 collagenous colitis patients and 38 matched healthy controls was analysed for autoantibodies--that is, antinuclear antibodies, antineutrophil cytoplasmic antibodies, smooth muscle and mitochondrial antibodies, rheumatoid factor and antibodies to thyroglobulin and microsomal antigen, together with antibodies to endomysium, gliadin, and cardiolipin. The serum values of IgA, IgG, IgM, and IgG-subclasses, and complement factors C3 and C4 were also determined. RESULTS: In patients with collagenous colitis the mean value of IgM was significantly increased 2.5 g/l (95% CI; 1.9, 3.2) compared with 1.4 g/l (95% CI; 1.2, 1.7) in controls (p = 0.002). Antinuclear antibodies occurred in nine of 38 patients compared with three of 38 controls, this difference was not statistically significant (p = 0.11). The results of all other immunoglobulins, complement factors, and specific antibodies showed no statistical difference between patients and controls. CONCLUSIONS: No firm evidence for an autoimmune genesis in collagenous colitis is found in this study, although the findings of a positive ANA-titre in some patients and an increased IgM level might give some support for this hypothesis.
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Selected References
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- Andersen P., Small J. V., Sobieszek A. Studies on the specificity of smooth-muscle antibodies. Clin Exp Immunol. 1976 Oct;26(1):57–66. [PMC free article] [PubMed] [Google Scholar]
- Bogomoletz W. V. Collagenous, microscopic and lymphocytic colitis. An evolving concept. Virchows Arch. 1994;424(6):573–579. doi: 10.1007/BF00195769. [DOI] [PubMed] [Google Scholar]
- Bohr J., Tysk C., Eriksson S., Järnerot G. Collagenous colitis in Orebro, Sweden, an epidemiological study 1984-1993. Gut. 1995 Sep;37(3):394–397. doi: 10.1136/gut.37.3.394. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Decraene T., Vandewalle C., Pipeleers D., Gorus F. K. Increased concentrations of total IgM at clinical onset of type 1 (insulin-dependent) diabetes: correlation with IgM binding to cells. The Belgian Diabetes Registry. Clin Chem. 1992 Sep;38(9):1762–1767. [PubMed] [Google Scholar]
- Duerr R. H., Targan S. R., Landers C. J., Sutherland L. R., Shanahan F. Anti-neutrophil cytoplasmic antibodies in ulcerative colitis. Comparison with other colitides/diarrheal illnesses. Gastroenterology. 1991 Jun;100(6):1590–1596. doi: 10.1016/0016-5085(91)90657-7. [DOI] [PubMed] [Google Scholar]
- European Helicobacter pylori study group. VIIIth International Workshop on Gastro-duodenal Pathology and Helicobacter pylori. Edinburgh, Scotland, 7-9 July 1995. Abstracts. Gut. 1995;37 (Suppl 1):A1–103. [PMC free article] [PubMed] [Google Scholar]
- Fagraeus A., Bergquist N. R. The raison d'etre of standards in indirect immunofluorescence. Ann N Y Acad Sci. 1975 Jun 30;254:69–76. doi: 10.1111/j.1749-6632.1975.tb29158.x. [DOI] [PubMed] [Google Scholar]
- Giardiello F. M., Lazenby A. J., Bayless T. M., Levine E. J., Bias W. B., Ladenson P. W., Hutcheon D. F., Derevjanik N. L., Yardley J. H. Lymphocytic (microscopic) colitis. Clinicopathologic study of 18 patients and comparison to collagenous colitis. Dig Dis Sci. 1989 Nov;34(11):1730–1738. doi: 10.1007/BF01540051. [DOI] [PubMed] [Google Scholar]
- Giardiello F. M., Lazenby A. J., Yardley J. H., Bias W. B., Johnson J., Alianiello R. G., Bedine M. S., Bayless T. M. Increased HLA A1 and diminished HLA A3 in lymphocytic colitis compared to controls and patients with collagenous colitis. Dig Dis Sci. 1992 Apr;37(4):496–499. doi: 10.1007/BF01307569. [DOI] [PubMed] [Google Scholar]
- Greenson J. K., Giardiello F. M., Lazenby A. J., Peña S. A., Bayless T. M., Yardley J. H. Antireticulin antibodies in collagenous and lymphocytic (microscopic) colitis. Mod Pathol. 1990 May;3(3):259–260. [PubMed] [Google Scholar]
- Grouls V., Vogel J., Sorger M. Collagenous colitis. Endoscopy. 1982 Jan;14(1):31–33. doi: 10.1055/s-2007-1021570. [DOI] [PubMed] [Google Scholar]
- Harris E. N. Special report. The Second International Anti-cardiolipin Standardization Workshop/the Kingston Anti-Phospholipid Antibody Study (KAPS) group. Am J Clin Pathol. 1990 Oct;94(4):476–484. doi: 10.1093/ajcp/94.4.476. [DOI] [PubMed] [Google Scholar]
- Jessurun J., Yardley J. H., Giardiello F. M., Hamilton S. R., Bayless T. M. Chronic colitis with thickening of the subepithelial collagen layer (collagenous colitis): histopathologic findings in 15 patients. Hum Pathol. 1987 Aug;18(8):839–848. doi: 10.1016/s0046-8177(87)80059-x. [DOI] [PubMed] [Google Scholar]
- Järnerot G., Tysk C., Bohr J., Eriksson S. Collagenous colitis and fecal stream diversion. Gastroenterology. 1995 Aug;109(2):449–455. doi: 10.1016/0016-5085(95)90332-1. [DOI] [PubMed] [Google Scholar]
- Kilander A. F., Dotevall G., Fällström S. P., Gillberg R. E., Nilsson L. A., Tarkowski A. Evaluation of gliadin antibodies for detection of coeliac disease. Scand J Gastroenterol. 1983 May;18(3):377–383. doi: 10.3109/00365528309181610. [DOI] [PubMed] [Google Scholar]
- Klatskin G., Kantor F. S. Mitochondrial antibody in primary biliary cirrhosis and other diseases. Ann Intern Med. 1972 Oct;77(4):533–541. doi: 10.7326/0003-4819-77-4-533. [DOI] [PubMed] [Google Scholar]
- Kozin F., Fowler M., Koethe S. M. A comparison of the sensitivities and specificities of different substrates for the fluorescent antinuclear antibody test. Am J Clin Pathol. 1980 Dec;74(6):785–790. doi: 10.1093/ajcp/74.6.785. [DOI] [PubMed] [Google Scholar]
- Lindström C. G. 'Collagenous colitis' with watery diarrhoea--a new entity? Pathol Eur. 1976;11(1):87–89. [PubMed] [Google Scholar]
- Löfgren J., Järnerot G., Danielsson D., Hemdal I. Incidence and prevalence of primary biliary cirrhosis in a defined population in Sweden. Scand J Gastroenterol. 1985 Jun;20(5):647–650. doi: 10.3109/00365528509089711. [DOI] [PubMed] [Google Scholar]
- Mogensen A. M., Olsen J. H., Gudmand-Høyer E. Collagenous colitis. Acta Med Scand. 1984;216(5):535–540. doi: 10.1111/j.0954-6820.1984.tb05043.x. [DOI] [PubMed] [Google Scholar]
- Pariente E. A., Chaumette M. T., Maître F., Delchier J. C., Soulé J. C., Bader J. P. Colite collagène, déficit en IgA, maladie de Basedow et gastrite atrophique. Gastroenterol Clin Biol. 1985 Oct;9(10):738–741. [PubMed] [Google Scholar]
- Pierrugues R., Bories P., Barnéon G., Bernard N., Michel H. La colite collagène. Réflexions à propos de 40 malades. Gastroenterol Clin Biol. 1989 Oct;13(10):811–815. [PubMed] [Google Scholar]
- Pieterse A. S., Hecker R., Rowland R. Collagenous colitis: a distinctive and potentially reversible disorder. J Clin Pathol. 1982 Mar;35(3):338–340. doi: 10.1136/jcp.35.3.338. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pimentel R. R., Achkar E., Bedford R. Collagenous colitis. A treatable disease with an elusive diagnosis. Dig Dis Sci. 1995 Jun;40(6):1400–1404. doi: 10.1007/BF02065559. [DOI] [PubMed] [Google Scholar]
- Reunala T., Chorzelski T. P., Viander M., Sulej J., Vainio E., Kumar V., Beutner E. H. IgA anti-endomysial antibodies in dermatitis herpetiformis: correlation with jejunal morphology, gluten-free diet and anti-gliadin antibodies. Br J Dermatol. 1987 Aug;117(2):185–191. doi: 10.1111/j.1365-2133.1987.tb04115.x. [DOI] [PubMed] [Google Scholar]
- Roubenoff R., Ratain J., Giardiello F., Hochberg M., Bias W., Lazenby A., Yardley J. Collagenous colitis, enteropathic arthritis, and autoimmune diseases: results of a patient survey. J Rheumatol. 1989 Sep;16(9):1229–1232. [PubMed] [Google Scholar]
- Sloth H., Bisgaard C., Grove A. Collagenous colitis: a prospective trial of prednisolone in six patients. J Intern Med. 1991 May;229(5):443–446. doi: 10.1111/j.1365-2796.1991.tb00372.x. [DOI] [PubMed] [Google Scholar]
- Snook J. Are the inflammatory bowel diseases autoimmune disorders? Gut. 1990 Sep;31(9):961–963. doi: 10.1136/gut.31.9.961. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sylwestrowicz T., Kelly J. K., Hwang W. S., Shaffer E. A. Collagenous colitis and microscopic colitis: the watery diarrhea-colitis syndrome. Am J Gastroenterol. 1989 Jul;84(7):763–768. [PubMed] [Google Scholar]
- Tarkowski A., Bjursten L. M., Nilsson L. A., Nygren H. False positive results in class-specific rheumatoid factor (RF) assays due to interaction between RF and Fc fragments of anti-immunoglobulin indicator reagents. J Immunol Methods. 1983 Mar 11;58(1-2):171–182. doi: 10.1016/0022-1759(83)90273-9. [DOI] [PubMed] [Google Scholar]
- Yang P., Järnerot G., Danielsson D., Tysk C., Lindberg E. P-ANCA in monozygotic twins with inflammatory bowel disease. Gut. 1995 Jun;36(6):887–890. doi: 10.1136/gut.36.6.887. [DOI] [PMC free article] [PubMed] [Google Scholar]