Title: Microscopic colitis found together with celiac disease in a female population is associated
with one episode of lymphocytic colitis
Version: 0 Date: 09 Jan 2024
Reviewer's report:
Here, the association between microscopic colitis (MC) and celiac disease (CD) was investigated
in collagenous colitis (n=92) and lymphocytic colitis (n=66) patients or MC with one episode
of the disease (n=70) and refractory MC (n=88).
MC and CD coexisted in half of the cases. Celiac disease was most prevalent in LC (12.1%
vs. 3.3%; p=0.05) and MC with one episode (12.9% vs. 2.3%; p=0.01). Anti-transglutaminase
antibodies were found in one patient with one episode of MC. Corticosteroid therapy was
most often found in CC (37.0% vs. 21.2%; p=0.037) and refractory MC (38.6% vs. 20.0%;
p=0.015). Past smokers were most prevalent in patient with one episode of MC (54.3 vs.
29.5%; p=0.007). Current smoking was the smoking habit with highest prevalence of IBS-like
symptoms. Interestingly, when adjusted for smoking habits, CD was significantly associated
with LC (OR: 4.222) and tended to be inversely associated with refractory MC
The authors concluded that CD is most common in patients with one episode of LC. Whether
LC in combination with CD should be classified as a CD entity or two different entities remains
to be further investigated.
The study investigate a clinically important topic. I have the following comments:
-a more detailed description of diagnostic criteria used for MC and CD diagnosis should be
described.
-regarding the risk of MC, a higher risk of MC development has been previously related to
suboptimal or low adherence to gluten-free diet. The authors should specific whether this
important issue has been investigated in their CD patients. In this regard, it has been reported
that celiac disease diagnosed through screening programs in at-risk adults is not associated with
worse adherence to the gluten-free diet and might protect from complications such as MC or
metabolic bone disease (Nutrients. 2018 Dec 7;10(12):1940. doi: 10.3390/nu10121940.)
-The association between CD and MC has been described as well as with refractory CD
and literature data should be recalled and compared with study results (Dig Dis Sci. 2022
Aug;67(8):3529-3542. doi: 10.1007/s10620-021-07232-7; Clin Gastroenterol Hepatol. 2009
Nov;7(11):1210-6. doi: 10.1016/j.cgh.2009.07.011; J Coll Physicians Surg Pak. 2015 Apr;25
Suppl 1:S14-6.)
Title: Microscopic colitis found together with celiac disease in a female population is associated
with one episode of lymphocytic colitis
Version: 0 Date: 09 Jan 2024
Reviewer's report:
Here, the association between microscopic colitis (MC) and celiac disease (CD) was investigated
in collagenous colitis (n=92) and lymphocytic colitis (n=66) patients or MC with one episode
of the disease (n=70) and refractory MC (n=88).
MC and CD coexisted in half of the cases. Celiac disease was most prevalent in LC (12.1%
vs. 3.3%; p=0.05) and MC with one episode (12.9% vs. 2.3%; p=0.01). Anti-transglutaminase
antibodies were found in one patient with one episode of MC. Corticosteroid therapy was
most often found in CC (37.0% vs. 21.2%; p=0.037) and refractory MC (38.6% vs. 20.0%;
p=0.015). Past smokers were most prevalent in patient with one episode of MC (54.3 vs.
29.5%; p=0.007). Current smoking was the smoking habit with highest prevalence of IBS-like
symptoms. Interestingly, when adjusted for smoking habits, CD was significantly associated
with LC (OR: 4.222) and tended to be inversely associated with refractory MC
The authors concluded that CD is most common in patients with one episode of LC. Whether
LC in combination with CD should be classified as a CD entity or two different entities remains
to be further investigated.
The study investigate a clinically important topic. I have the following comments:
-a more detailed description of diagnostic criteria used for MC and CD diagnosis should be
described.
-regarding the risk of MC, a higher risk of MC development has been previously related to
suboptimal or low adherence to gluten-free diet. The authors should specific whether this
important issue has been investigated in their CD patients. In this regard, it has been reported
that celiac disease diagnosed through screening programs in at-risk adults is not associated with
worse adherence to the gluten-free diet and might protect from complications such as MC or
metabolic bone disease (Nutrients. 2018 Dec 7;10(12):1940. doi: 10.3390/nu10121940.)
-The association between CD and MC has been described as well as with refractory CD
and literature data should be recalled and compared with study results (Dig Dis Sci. 2022
Aug;67(8):3529-3542. doi: 10.1007/s10620-021-07232-7; Clin Gastroenterol Hepatol. 2009
Nov;7(11):1210-6. doi: 10.1016/j.cgh.2009.07.011; J Coll Physicians Surg Pak. 2015 Apr;25
Suppl 1:S14-6.)
Please review this paper.
user
Title: Microscopic colitis found together with celiac disease in a female population is associated
with one episode of lymphocytic colitis
Version: 0 Date: 09 Jan 2024
Reviewer's report:
Here, the association between microscopic colitis (MC) and celiac disease (CD) was investigated
in collagenous colitis (n=92) and lymphocytic colitis (n=66) patients or MC with one episode
of the disease (n=70) and refractory MC (n=88).
MC and CD coexisted in half of the cases. Celiac disease was most prevalent in LC (12.1%
vs. 3.3%; p=0.05) and MC with one episode (12.9% vs. 2.3%; p=0.01). Anti-transglutaminase
antibodies were found in one patient with one episode of MC. Corticosteroid therapy was
most often found in CC (37.0% vs. 21.2%; p=0.037) and refractory MC (38.6% vs. 20.0%;
p=0.015). Past smokers were most prevalent in patient with one episode of MC (54.3 vs.
29.5%; p=0.007). Current smoking was the smoking habit with highest prevalence of IBS-like
symptoms. Interestingly, when adjusted for smoking habits, CD was significantly associated
with LC (OR: 4.222) and tended to be inversely associated with refractory MC
The authors concluded that CD is most common in patients with one episode of LC. Whether
LC in combination with CD should be classified as a CD entity or two different entities remains
to be further investigated.
The study investigate a clinically important topic. I have the following comments:
-a more detailed description of diagnostic criteria used for MC and CD diagnosis should be
described.
-regarding the risk of MC, a higher risk of MC development has been previously related to
suboptimal or low adherence to gluten-free diet. The authors should specific whether this
important issue has been investigated in their CD patients. In this regard, it has been reported
that celiac disease diagnosed through screening programs in at-risk adults is not associated with
worse adherence to the gluten-free diet and might protect from complications such as MC or
metabolic bone disease (Nutrients. 2018 Dec 7;10(12):1940. doi: 10.3390/nu10121940.)
-The association between CD and MC has been described as well as with refractory CD
and literature data should be recalled and compared with study results (Dig Dis Sci. 2022
Aug;67(8):3529-3542. doi: 10.1007/s10620-021-07232-7; Clin Gastroenterol Hepatol. 2009
Nov;7(11):1210-6. doi: 10.1016/j.cgh.2009.07.011; J Coll Physicians Surg Pak. 2015 Apr;25
Suppl 1:S14-6.)
assistant