Clinical Research
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jan 14, 2008; 14(2): 231-235
Published online Jan 14, 2008. doi: 10.3748/wjg.14.231
Clear cell colitis: A form of microscopic colitis in children
Jan Józefczuk, Bogdan Marian Wozniewicz
Jan Józefczuk, Pediatric Division, City Hospital, 39-360 Nowa Deba, M. Curie Sklodowska 1, Poland
Bogdan Marian Wozniewicz, Department of Pathology, The Children’s Memorial Health Institute, Aleja Dzieci Polskich 20, Warsaw 04-730, Poland
Correspondence to: Bogdan Marian Wozniewicz, MD, PhD, Department of Pathology, The Children’s Memorial Health Institute, Aleja Dzieci Polskich 20, Warsaw 04-730, Poland. b.wozniewicz@czd.waw.pl
Telephone: +48-22-8151972
Fax: +48-22-8722189
Received: October 10, 2006
Revised: September 25, 2007
Published online: January 14, 2008
Abstract

AIM: To describe a new clinical and pathological subtype of microscopic colitis in children.

METHODS: A selected group of children with abdominal pain, constipation and/or diarrhoea showing discrete or no macroscopic abnormalities on endoscopy was described.

RESULTS: Multiple biopsies of colon showed large mononuclear clear cells in lamina propria of mucous membrane provided that good quality histological sections were performed and observed under a higher magnification. Otherwise, they could be misinterpreted as artefacts. Their presence in routine histology might suggest a systemic storage disease (Whipple’s disease), and neuronal intestine dysplasia. Using immunohistochemical staining and electron microscopy we confirmed their origin from CD68 positive mononuclear macrophages.

CONCLUSION: The presence of large clear cells is a constant microscopic feature. Failure of transient large bowel stationary macrophages plays a role in the pathogenesis of this benign microscopic clear cell colitis, sometimes coexisting with allergy.

Keywords: Microscopic colitis; Clear cell colitis; Diarrhoea; Constipation; Abdominal pain; Children; Allergy; Endoscopy