Results of therapy of microscopic colitis with presence of foamy macrophages in children

Abstract

Introduction and aim of the study: Evaluation of efficacy of 5-amino-2-hydroxybenzoic acid (5-ASA) or Saccharomyces boulardii in therapy of microscopic colitis with presence of foamy macrophages. Material and methods: 109 children with colitis treated with 5-ASA (38 children) - group A or with Saccharomyces boulardii (35 children) - group B during a period of 12 months were included in the analysis. 36 children who required no treatment - group C - constituted a control group. Diagnosis of the disease was determined based on medical history and endoscopic examination of the large intestine. A result of microscopic examination of hematoxylin and eosin-stained specimens reviewed under ×320 magnification, revealing presence of characteristic foamy macrophages constituted a basis for inclusion to study groups. Clinical and endoscopic evaluation based on Rachmilewitz score was performed at diagnosis and following 12 months of therapy. Intensity of lesions found at microscopic examination was evaluated based on an internal triple-grade scale. Results: No statistically significant improvement was found following the use of 5-ASA in therapy of the disease. The use of Saccharomyces boulardii was associated with a statistically significant improvement in clinical, endoscopic and histopathological condition. In the group of children in whom no therapeutic intervention was provided, a statistically significant spontaneous clinical improvement was observed, but no statistically significant changes in endoscopic and microscopic condition were found. Conclusions: Efficacy of the therapy with probiotic Saccharomyces boulardii was confirmed in patients with microscopic colitis with presence of foamy macrophages (group B). No fitness of 5-ASA for therapy of the disease was demonstrated (group A). Untreated children present a tendency for spontaneous clinical remission. A 12-month follow-up in that group showed no progression of endoscopic and microscopic lesions (group C). © 2011 Cornetis.