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Incidence, Clinical Presentation, and Associated Factors of Microscopic Colitis in Northern France: A Population-Based Study

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Abstract

Objective

To date, there are no epidemiological data on microscopic colitis (MC) in France. The aim of this study was to determine the incidence of MC in the Somme department in Northern France, to evaluate clinical characteristics, and to search for risk factors for both collagenous colitis (CC) and lymphocytic colitis (LC).

Design

Between January 1, 2005, and December 31, 2007, four pathology units in the Somme department recorded all new cases of MC diagnosed in patients living in the area. Colonic biopsies were reviewed by 4 pathologists together. For each incident case, demographic, clinical, endoscopic, and biological data were collected according to methodology of the EPIMAD registry.

Results

One hundred and thirty cases of MC, including 87 CC and 43 LC, were recorded during the three-year study. The mean annual incidence for MC was 7.9/105 inhabitants, 5.3/105 inhabitants for CC, and 2.6/105 inhabitants for LC. Annual standardized incidence of Crohn’s disease and ulcerative colitis in the EPIMAD registry during the same period (2005–2007) were 7.4/105 and 4.9/105, respectively. Median age at diagnosis was 63 years for MC, 70 for CC, and 48 for LC. The female-to-male gender ratio was 3.5 for MC, 4.1 for CC, and 2.6 for LC. Median time to diagnosis was 8 weeks. Chronic diarrhea and abdominal pain were, respectively, present in 93 and 47 % of the cases. An autoimmune disease was associated in 28 % of MC cases. At diagnosis, proton pump inhibitor treatment was more often reported in CC than in LC (46 vs 16 %; p = 0.003). Budesonide was effective on diarrhea in 77 % of patients, and thirteen percent of patients became steroid dependent.

Conclusion

This population-based study shows that the incidence of MC in France is high and similar to Crohn’s disease incidence and confirms that this condition is associated with female gender, autoimmune diseases, and medications.

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Abbreviations

MC:

Microscopic colitis

CC:

Collagenous colitis

LC:

Lymphocytic colitis

NSAIDs:

Nonsteroidal anti-inflammatory drugs

PPIs:

Proton pump inhibitors

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Somme Microscopic colitis study group:

Gastroenterologists E. Bartoli, A. Bental, F. Brazier, J. Butel, D. Capron-Chivrac, H. Coevoet, G. Cohen, I. Dadamessi, R. Delcenserie, T. Delgrange, P. Descombes, JL. Dupas, B. Heyman, JP. Joly, M. Lagarde, D. Laude, H. Mancheron, E. Nguyen-Khac, A. Papazian, B. Pauwels, M. Pauwels, JC. Prevost, N. Reix-Branche, A. Rudelli, F. Sevenet, C. Triplet, M. Wantiez.

Pathologists

D. Chatelain, C. Cordonnier-Bryselbout, C. Ghighi, F. Lamarche, C. Lelarge, F. Nagorniewicz, J. Petit, T. Petit, P. Richard, H. Sevestre, F. Thelu

Author contributions

M. Fumery: Concept and study design, interpretation of data, drafting of the manuscript, M. Kohut: Concept and study design, data collection, interpretation of data, critical revision of the manuscript, C. Gower-Rousseau: Concept and study design, critical revision of the manuscript, A. Duhamel: Statistical analysis, critical revision of the manuscript, F. Brazier: Critical revision of the manuscript, F. Thelu: Pathology, slide reading, F. Nagorniewicz: Pathology, slide reading, F. Lamarche: Pathology, slide reading, E. Nguyen-Khac: Concept and study design, critical revision of the manuscript, C. Sabbagh: Interpretation of data, critical revision of the manuscript, J. Loreau: Data collection, interpretation of data, J. F. Colombel: Concept and study design, critical revision of the manuscript, G. Savoye: Concept and study design, critical revision of the manuscript, D. Chatelain: Concept and study design, pathology, slide reading, critical revision of the manuscript, J. L. Dupas: Concept and study design, interpretation of data, drafting of the manuscript and critical revision of the manuscript.

Author information

Author notes

    Authors and Affiliations

    1. Service d’hepatogastroenterologie, Gastroenterology Unit, Amiens University and Hospital, Université de Picardie Jules Verne, Avenue Laennec-Salouel, 80000, Amiens, France

      Mathurin Fumery, Franck Brazier, Eric Nguyen-Khac, Julien Loreau & Jean-Louis Dupas

    2. EPIMAD registry, Amiens, France

      Mathurin Fumery, Franck Brazier & Jean-Louis Dupas

    3. Gastroenterology, St. Isabelle Clinic, Abbeville, France

      Mathieu Kohut

    4. LIRIC-UMR 995 INSERM, IBD team and Environmental Factors: Epidemiology and Functional Analyses, Lille University, Lille, France

      Corinne Gower-Rousseau

    5. Public Health, Epidemiology and Economic Health, EPIMAD registry, Regional Clinical Research Center, Lille University and Hospital, Cedex, France

      Corinne Gower-Rousseau

    6. Biostatistics Unit, CERIM, EA2694, Lille University and Hospital, Lille, France

      Alain Duhamel

    7. Pathology Laboratory, 40 rue Andre Chenier, 80000, Amiens, France

      Francoise Thelu

    8. Pathology Laboratory, 51 Rue Jeanne d’Arc, 80000, Amiens, France

      Francis Nagorniewicz

    9. Pathology Laboratory, 13 Rue Sainte-Catherine, 80100, Abbeville, France

      Francois Lamarche

    10. Department of Digestive Surgery, Amiens University Hospital, Amiens, France

      Charles Sabbagh

    11. Dr. Henry D Janowitz, Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

      Jean-Frederic Colombel

    12. Gastroenterology Unit, EPIMAD registry, Rouen University and Hospital, Rouen, France

      Guillaume Savoye

    13. Pathology Unit, Amiens University and Hospital, Picardie University Jules Verne, Amiens, France

      Denis Chatelain

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    1. Mathurin Fumery
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    Consortia

    On behalf on the Somme MC group

    • E. Bartoli
    • , A. Bental
    • , F. Brazier
    • , J. Butel
    • , D. Capron-Chivrac
    • , H. Coevoet
    • , G. Cohen
    • , I. Dadamessi
    • , R. Delcenserie
    • , T. Delgrange
    • , P. Descombes
    • , J. L. Dupas
    • , B. Heyman
    • , J. P. Joly
    • , M. Lagarde
    • , D. Laude
    • , H. Mancheron
    • , E. Nguyen-Khac
    • , A. Papazian
    • , B. Pauwels
    • , M. Pauwels
    • , J. C. Prevost
    • , N. Reix-Branche
    • , A. Rudelli
    • , F. Sevenet
    • , C. Triplet
    •  & M. Wantiez

    EPIMAD group

    Corresponding author

    Correspondence to Mathurin Fumery.

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    Conflict of interest

    There is no conflict of interest for this manuscript.

    Additional information

    Mathurin Fumery and Mathieu Kohut have contributed equally to this work.

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    Fumery, M., Kohut, M., Gower-Rousseau, C. et al. Incidence, Clinical Presentation, and Associated Factors of Microscopic Colitis in Northern France: A Population-Based Study. Dig Dis Sci 62, 1571–1579 (2017). https://doi.org/10.1007/s10620-016-4306-z

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    • DOI: https://doi.org/10.1007/s10620-016-4306-z

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