| Theme | Atypical cases of inflammatory bowel disease diagnosed with difficulty | |
|---|---|---|
| Title | Clinical study of causation between benign rectal lymphoid follicular hyperplasia and ulcerative colitis | |
| Publish Date | 2016/11 | |
| Author | Hiroshi Fujita | Department of Gastroenterology, Nisshin Orido Hospital |
| Author | Mitsuo Nagasaka | Department of Gastroenterology, Fujita Health University School of Medicine |
| Author | Ichiro Hirata | Department of Gastroenterology, National Federation of Health Insurance Societies Osaka-Central Hospital |
| Author | Naoki Omiya | Department of Gastroenterology, Fujita Health University School of Medicine |
| Author | Makoto Urano | Department of Pathology, Fujita Health University School of Medicine |
| Author | Tenzo Shiraishi | Department of Gastroenterology, Nisshin Orido Hospital |
| Author | Shigeo Endo | Department of Gastroenterology, Nisshin Orido Hospital |
| Author | Mitsumasa Koike | Department of Gastroenterology, Nisshin Orido Hospital |
| Author | Junji Yoshino | Department of Gastroenterology, Fujita Health University Banbuntane Hospital |
| Author | Nobuyuki Hattori | Department of Gastroenterology, Fujita Health University Banbuntane Hospital |
| Author | Kunio Toyama | Nogaki Hospia |
| Author | Makoto Sanomura | Hokusetsu Genaral Hospital |
| [ Summary ] | According to several recent studies, benign and diffuse rectal lymphoid follicular hyperplasia (BDRLH) without Chlamydia infection or Crohn's disease, is an initial lesion associated with ulcerative colitis. However, there is little clinical data or colonoscopic findings to substantiate this. The aim of this study was to evaluate the detailed clinical aspects and colonoscopic findings observed in patients with lymphoid follicular proctitis (LFP) and with ulcerative proctitis (UP). Moreover, we investigated the causative links between both diseases and ulcerative colitis. The important colonoscopic findings which distinguish UP from LFP, were evidence of erosion of the appendiceal orifice, tiny mucosal defects and invisible vascular patterns. In order to diagnose LFP easily, we should spray indigo carmine when we observe multiple irregular halation with colonoscopy. Our data suggest that UP was significantly correlated to chronic ulcerative colitis. On the other hand, LFP was not related to chronic ulcerative colitis. LFP as a form of nodular lymphoid hyperplasia may be rare. Furthermore, strict long term follow-ups are necessary for both diseases in connection with multicenter trials. | |