CLINICAL AND HISTOLOGICAL FEATURES OF RELAPSED PATIENTS OF ULCERATIVE COLITIS
Main Article Content
Keywords
ulcerative colitis, histological features, vague abdominal pain, cryptitis
Abstract
Objectives:
To determine the clinical and histological features observed in patients experiencing relapses of ulcerative colitis.
Materials and Methods: This cross sectional study was conducted at Department of Medicine, Ziauddin University, Karachi, Pakistan. We have enrolled 192 patients with ulcerative colitis. The study was conducted from 1st January, 2023 to 31 December, 2023. Mucosal tissue biopsies underwent processing in an automatic tissue processor over a period of 16 hours overnight. The tissues were dehydrated using ethyl alcohol, cleared with xylene, and impregnated with paraffin wax, after which tissue blocks were formed. Subsequently, hematoxylin and eosin stains were applied.
Results: The mean age of the 192 patients was 41.54 ± 10.25 years. Among them, 110 (57.3%) were male, and 82 (42.7%) were female. The primary presenting complaint in UC patients is vague abdominal pain (53.1%), predominantly observed in the 36-50 age group, followed by per rectal bleeding (39.6%), which is more frequently reported in the same age range. The two most prevalent histological features observed are cryptitis, present in 100.0% of patients across all age groups, followed by chronic inflammation, present in 188 cases (97.9%).
Conclusion: It was concluded that in relapsed cases, vague abdominal pain is the main presentation, with cryptitis as the most common histological feature in ulcerative colitis.
References
2. Wei S-C, Sollano J, Hui YT, Yu W, Santos Estrella PV, Llamado LJQ, et al. Epidemiology, burden of disease, and unmet needs in the treatment of ulcerative colitis in Asia. Expert Review of Gastroenterology & Hepatology. 2021;15(3):275-89.
3. Prideaux L, Kamm MA, De Cruz PP, Chan FK, Ng SC. Inflammatory bowel disease in Asia: a systematic review. Journal of gastroenterology and hepatology. 2012;27(8):1266-80.
4. Ooi CJ, Fock KM, Makharia GK, Goh KL, Ling KL, Hilmi I, et al. The Asia‐Pacific consensus on ulcerative colitis. Journal of gastroenterology and hepatology. 2010;25(3):453-68.
5. Khokhar N. Ulcerative colitis: experience at a tertiary care center. Rawal Med J. 2005;30:12-5.
6. QURESHI H, ZUBERI SJ, BANATWALA N, ANWAR A, SHAMSI Z, KHAN MN. Ulcerative colitis in Karachi. Journal of gastroenterology and hepatology. 1989;4(4):313-6.
7. Hameed K, Shah S. Correlationof endoscopic extent and severity with the clinical presentationof ulcerative colitis. JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2001;11(9):551-3.
8. Thompson AI, Lees CW. Genetics of ulcerative colitis. Inflammatory bowel diseases. 2011;17(3):831-48.
9. Khan MJ, ur Rehman A, Sahrish F, Mukhtar R, Ilyas A, Aamir Z. Clinical Features and Histological Features of Relapsed Patients of Ulcerative Colitis. Pakistan Journal of Medical & Health Sciences. 2022;16(02):262-.
10. Zhang Y-Z, Li Y-Y. Inflammatory bowel disease: pathogenesis. World journal of gastroenterology: WJG. 2014;20(1):91.
11. Yangyang RY, Rodriguez JR, editors. Clinical presentation of Crohn’s, ulcerative colitis, and indeterminate colitis: Symptoms, extraintestinal manifestations, and disease phenotypes. Seminars in pediatric surgery; 2017: Elsevier.
12. Bernstein CN, Fried M, Krabshuis J, Cohen H, Eliakim R, Fedail S, et al. World Gastroenterology Organization Practice Guidelines for the diagnosis and management of IBD in 2010. Inflammatory bowel diseases. 2010;16(1):112-24.
13. Bitton A, Peppercorn MA, Antonioli DA, Niles JL, Shah S, Bousvaros A, et al. Clinical, biological, and histologic parameters as predictors of relapse in ulcerative colitis. Gastroenterology. 2001;120(1):13-20.
14. Bryant RV, Burger DC, Delo J, Walsh AJ, Thomas S, von Herbay A, et al. Beyond endoscopic mucosal healing in UC: histological remission better predicts corticosteroid use and hospitalisation over 6 years of follow-up. Gut. 2016;65(3):408-14.
15. Jauregui-Amezaga A, Geerits A, Das Y, Lemmens B, Sagaert X, Bessissow T, et al. A simplified Geboes score for ulcerative colitis. Journal of Crohn's and Colitis. 2017;11(3):305-13.
16. Park SH, Kim YM, Yang S-K, Kim S-H, Byeon J-S, Myung S-J, et al. Clinical features and natural history of ulcerative colitis in Korea. Inflammatory bowel diseases. 2007;13(3):278-83.
17. Melson JE, Giusto D, Kwasny M, Eichenseer P, Jakate S, Keshavarzian A. Histopathology predictors of medically refractory ulcerative colitis. Diseases of the colon & rectum. 2010;53(9):1280-6.
18. Azad S, Sood N, Sood A. Biological and histological parameters as predictors of relapse in ulcerative colitis: a prospective study. Saudi Journal of Gastroenterology. 2011;17(3):194-8.
19. REHMAN AU, YASIR F, JAVAID K. The Histopathological Diagnosis of Ulcerative Colitis on Non-Neoplastic Colorectal Biopsies–An Audit. Journal of Fatima Jinnah Medical University. 2013;7(2).
20. Riley S, Mani V, Goodman M, Dutt S, Herd M. Microscopic activity in ulcerative colitis: what does it mean? Gut. 1991;32(2):174-8.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr Sohail Hussain
MBBS, FCPS, MACG, Assistant Professor, Consultant Gastroenterologist and Hepatologist Clinical Coordinator for Postgraduate Studies, Ziauddin University Karachi, Pakistan
Dr Imtiaz Begum
MBBS, MRCP, Associate Professor, Department of Medicine, Ziauddin University, Karachi, Pakistan
Dr Syed Ali Raza
Assistant Professor and Unit Head of Medicine, Consultant Physician, Ziauddin Medical University/Dr Ziauddin Hospital, Pakistan
Dr Faiza Nafees Khan
MBBS, FCPS-Nephrology, MASN, Assistant Professor/ Consultant Nephrologist, Department of Nephrology, Clinical Coordinator for Undergraduate Studies and Internship Programme for MBBS, Ziauddin University Hospital Karachi, Pakistan
Dr Tauseef Ahmad
MBBS, FCPS, Assistant Professor, Consultant Physician, Ziauddin University Hospital Karachi, Pakistan
Dr Muhammad Kamran
MBBS, FCPS (Gastroenterology), Assistant Professor, Fazaia Ruth PFAU Medical College and Teaching Hospital, Karachi, Pakistan