P4387 - Investigating the Natural Progression of Microscopic Colitis: Analysis of the Loyola University Microscopic Colitis Registry (LUMiCoR)

Karolina Krawczyk, MD, MS¹, Christopher Kujalowicz, BS², Dinkar Ahuja, MD³, Mohammed Abourahma, MD³, Ayokunle T. Abegunde, MD, MSc, MRCP, FACG^3
1Loyola University Medical Center, Harwood Heights, IL; ²Loyola University Chicago Stritch School of Medicine, Maywood, IL; ³Loyola University Medical Center, Maywood, IL

Introduction: Microscopic colitis (MC) is an inflammatory bowel disease (IBD) of the large intestine that presents as chronic watery diarrhea; it is characterized by normal-appearing colonic mucosa and it has two histologic subtypes: lymphocytic colitis (LC) and collagenous colitis (CC). There is limited knowledge about the natural progression of MC with time and with treatment. We aimed to investigate the progression of MC by describing the frequency of inflammatory bowel disease, pancreatitis, major adverse cardiovascular events, and malignancy after a diagnosis of MC.

Methods: We conducted a prospective survey of a population-based cohort of MC patients from the Loyola University Microscopic Colitis Registry (LUMiCoR). The registry includes all MC patients diagnosed at Loyola from 2008 and onwards. MC patients were invited to complete electronic questionnaires via the Qualtrics online survey platform. The survey included questions about demographics, microscopic colitis diagnosis subtype, treatments, and medical comorbidities. Responses were compared to each patient’s medical record for accuracy. Data were analyzed for descriptive statistics.

Results: Of 121 patients invited to complete the survey, 37 responded, resulting in a 31% response rate. The average age of respondents was 61 years, and 62% were female. Respondent frequencies are shown in Table 1. More than 50% of the respondents had received at least one course of Budesonide to treat MC. No respondents reported a diagnosis of colorectal, gastric, pancreatic, liver, gallbladder, or lung cancer after diagnosis of MC. Three of twenty-six respondents (10.34%) reported a diagnosis of pancreatitis, and 8% (3/37) of respondents reported having a MACE (CHF or CVA/TIA). The majority of respondents did not have a family history of celiac disease, colorectal cancer, and IBD and over 93% of respondents did not progress to CD or UC.

Discussion: MC does not appear to be associated with a family history or prior diagnosis of IBD. Our results suggest that the majority of MC patients do not develop colon or extra-colonic cancers, pancreatitis, or MACE. However, this study has limitations. We relied on patients' recall and understanding of their disease, and the low response rates may have led to sampling and non-response bias in our data.


Disclosures:


Karolina Krawczyk, MD, MS¹, Christopher Kujalowicz, BS², Dinkar Ahuja, MD³, Mohammed Abourahma, MD³, Ayokunle T. Abegunde, MD, MSc, MRCP, FACG³. P4387 - Investigating the Natural Progression of Microscopic Colitis: Analysis of the Loyola University Microscopic Colitis Registry (LUMiCoR), ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.