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Lymphocytic Colitis : Pathogenesis

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Like collagenous colitis (CC), the pathogenesis of lymphocytic colitis (LC) is immune-mediated and it has an even stronger association with Celiac disease than that between CC and Celiac disease. Exposure to one or more luminal antigens is required. Non-steroidal anti-inflammatory drugs, proton-pump inhibitors, selective serotonin uptake inhibitors (SSRIs), simvastatin, and lisinopril exposure have been associated with LC. There is increased incidence of HLA A1, DQ2, DQ1, and DQ3 in patients with LC.

This image shows the characteristic histologic features of LC - surface epithelial damage, increased intraepithelial lymphocytes, no increase in the thickness of subepithelial collagen, and normal crypt architecture.
Image credit: Copyright 2013 Michael Bonert, MD - Own work, CC BY-SA 3.0

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