Enterocolic lymphocytic phlebitis and lymphocytic colitis: drug-related coexistent pathology.

摘要

Dear Editor:Enterocolic lymphocytic phlebitis (ELP), a term coined in 1989, is an entity of unknown etiology and pathogenesis. This term is synonymous with mesenteric veno-occlusive disease, granulomatous phlebitis, necrotizing phlebitis, and myointimal hyperplasia. It is a spectrum of disease with lymphocytic phlebitis at one end of the spectrum, and thrombosis and myointimal hyperplasia at the other. ELP is a rare type of venulitis involving only the submucosal, subserosal, and mesenteric veins and venules of bowel wall. The arteries and arterioles, as well as the systemic circulation, are typically spared. Whilst a definitive cause has not been isolated, specific drugs have been associated with ELP.The entity of lymphocytic colitis (LC) was first described as "microscopic colitis" in 1980. An infiltrate of T lymphocytes within the epithelium in excess of 20 lymphocytes per 100 epithelial cells, features of epithelial injury, chronic inflammatory infiltrate in lamina propria, and absence of a prominent subepithelial collagen band, characterize LC histologically. The patients typically present with chronic diarrhea but the colon has a normal appearance endoscopically. LC was considered idiopathic until recently when infectious agents and drugs were proposed to be the possible triggers.