From the Guidelines
Lymphocytic Colitis (LC) and Microscopic Colitis (MC) have distinct etiologies, with LC being a subtype of MC. The main difference between LC and MC lies in their histological features, with LC characterized by an increased number of intraepithelial and lamina propria lymphocytes, while MC is a broader term that encompasses both LC and collagenous colitis [ 1 ].
Etiologies of LC and MC
- Autoimmune disorders: Both LC and MC have been associated with autoimmune disorders, such as rheumatic disease, thyroid disease, and celiac disease [ 1 ].
- Infections: Some studies suggest that infections, such as Clostridium difficile, may play a role in the development of MC [ 1 ].
- Drugs: Certain medications, such as nonsteroidal anti-inflammatory drugs, proton pump inhibitors, and selective serotonin reuptake inhibitors, may trigger or exacerbate MC [ 1 ].
- Genetic predisposition: Some individuals may be more susceptible to developing LC or MC due to genetic factors [ 1 ].
Key differences between LC and MC
- Histological features: LC is characterized by an increased number of intraepithelial and lamina propria lymphocytes, while MC is a broader term that encompasses both LC and collagenous colitis [ 1 ].
- Clinical presentation: Both LC and MC typically present with chronic watery diarrhea, but the severity and duration of symptoms may vary [ 1 ].
- Response to treatment: LC and MC may respond differently to treatment, with some patients requiring more aggressive therapy [ 1 ].
In summary, while LC and MC share some common etiologies, such as autoimmune disorders and infections, they have distinct histological features and clinical presentations. A thorough understanding of these differences is essential for accurate diagnosis and effective treatment [ 1 ].
From the Research
Etiologies of Lymphocytic Colitis (LC) and Microscopic Colitis (MC)
The etiologies of Lymphocytic Colitis (LC) and Microscopic Colitis (MC) are not fully understood, but several studies have investigated the potential causes and risk factors associated with these conditions.
- The pathogenesis of MC is largely unknown, but may relate to autoimmunity, adverse reactions to drugs or (bacterial) toxins, and abnormal collagen metabolism in the case of CC 2.
- Emerging studies suggest that a stepwise approach be taken in the medical management of MC, which includes antidiarrheal agents and stopping of any offending agents; budesonide or bismuth subsalicylate; and cholestyramine or 5-acetylsalicylic acid agents 3.
- Risk factors for MC include increasing age; female sex; presence of other autoimmune diseases; and possibly use of certain medications, including proton pump inhibitors, nonsteroidal anti-inflammatory drugs, selective serotonin reuptake inhibitors, and statins 4.
Comparison of LC and CC
Several studies have compared the clinical characteristics of LC and CC, which are considered two distinct disease entities.
- Despite similar clinical symptoms, collagenous colitis (CC) and lymphocytic colitis (LC) are considered two distinct disease entities, but some studies suggest that they could be subtypes of the same disease, microscopic colitis (MC) 5.
- An abnormal number of intraepithelial lymphocytes are found in 45% (40-50%) with CC, and an abnormal subepithelial collagen band in 16% (13-20%) with LC suggesting a histological overlap 5.
- Concomitant autoimmune diseases were more common in CC (53.3%) than in LC (25.9%; P = 0.017) 6.
Clinical Characteristics
The clinical characteristics of LC and CC are largely similar, but some differences have been observed.