The implication of microscopic ileitis finding in patients referred for ileocolonoscopy for clinically suspected inflammatory bowel disease (IBD) is not well defined, and its correlation with clinical outcome has not been fully studied. The current study aims to determine the prognostic yield of biopsies in this setting, and to evaluate the correlation of microscopic ileitis with long-term clinical outcome. We reviewed endoscopic reports of patients referred to our department for ileocolonoscopy in the years 2010–2016, as part of a diagnostic work-up for suspected IBD. Patients whose ileocolonoscopies proved normal were included, provided that terminal ileum biopsies had been performed. Accordingly, patients were divided into groups classified as normal (normal or reactive changes) and microscopic ileitis (inflammation or ileitis of any severity). Both groups were followed prospectively to determine clinical outcome. A total of 439 patients met the inclusion criteria. Sixty-four (14.6%) showed inflammation on biopsy and were included in the microscopic ileitis group. Age range and gender figures did not differ significantly between the groups. Overall follow-up period was 6.1 ± 2.3 years. Patients in the microscopic ileitis group were significantly associated with Crohn’s diagnosis during the follow-up period compared with the normal group (19% vs 2%, OR = 11.98, 95%CI = 4.48–32.01; p < 0.01). Patients with granuloma or moderate-severe ileitis on biopsy were significantly associated with Crohn’s development (100% vs 11%; P < 0.01) compared with mild or nonspecific inflammation. The discovery of microscopic ileitis in clinically suspected IBD is associated with increased risk of future diagnosis of Crohn’s disease.

中文翻译：

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临床疑似炎症性肠病患者的镜下回肠炎能否预测未来？


对于因临床疑似炎症性肠病（IBD）而转诊接受回肠结肠镜检查的患者，发现显微回肠炎的意义尚不明确，其与临床结果的相关性尚未得到充分研究。目前的研究旨在确定这种情况下活检的预后效果，并评估显微镜下回肠炎与长期临床结果的相关性。我们回顾了 2010 年至 2016 年转诊至我们科室进行回肠结肠镜检查的患者的内镜报告，作为疑似 IBD 诊断检查的一部分。回肠结肠镜检查证明正常的患者也被包括在内，前提是已进行了回肠末端活检。因此，患者被分为正常组（正常或反应性变化）和显微镜下回肠炎（任何严重程度的炎症或回肠炎）。对两组患者进行前瞻性随访以确定临床结果。共有 439 名患者符合纳入标准。 64 例（14.6%）在活检中显示炎症，被纳入显微回肠炎组。各组之间的年龄范围和性别数字没有显着差异。总体随访时间为 6.1 ± 2.3 年。与正常组相比，显微镜下回肠炎组患者在随访期间与克罗恩病诊断显着相关（19% vs 2%，OR = 11.98，95%CI = 4.48–32.01；p < 0.01）。与轻度或非特异性炎症相比，活检发现肉芽肿或中重度回肠炎的患者与克罗恩病的发生显着相关（100% vs 11%；P< 0.01）。在临床疑似 IBD 中发现微小回肠炎与未来诊断克罗恩病的风险增加相关。