Title: Microscopic colitis found together with celiac disease in a female population is associated
with one episode of lymphocytic colitis
Version: 0 Date: 01 Jan 2024
Reviewer's report:
In this study, the authors aimed  toinvestigate the association between Microscopic colitis (MC)
and celiac disease (CD).
Overall, they studied 158 women with MC. Participants completed a study questionnaire about
sociodemographic factors, lifestyle habits, and medical history; the Rome III questionnaire; and
the visual analog scale for irritable bowel syndrome (VAS-IBS). Patients were categorized into
collagenous colitis (CC, n=92) and lymphocytic colitis (LC, n=66) or MC with one episode of
the disease (n=70) and refractory MC (n=88). Differences between groups were calculated and
logistic regression was adjusted for smoking habits.
They found that MC and CD debuted simultaneously 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).
Corticosteroid use 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). When adjusted for smoking habits, CD  was associated with LC
(OR: 4.222; p=0.047) and tended to be inversely associated with refractory MC (OR: 0.210;
p=0.058). They concluded that CD is most common in patients with one episode of LC thus
leaving open the question of whether to consider LC in combination with CD as celiac disease
or two different entities.
The study is of interest, however important issues should be addressed.
-It is unclear whether the diagnosis of celiac disease was preexisting or was established only
after MC was diagnosed. The authors should more clearly expose the study design. The criteria
used for the diagnosis of both celiac disease and MC (collagenous and lymphocytic) should also
be well defined.
It is critical in this study to clearly report the temporal relationship between the diagnoses
of celiac disease and microscopic colitis because the authors concluded that it remains to be
determined whether LC should be classified as celiac disease. However, previous literature data
have indicated microscopic colitis as a possible complication of celiac disease, both in treated
and untreated celiac disease patients.
Title: Microscopic colitis found together with celiac disease in a female population is associated
with one episode of lymphocytic colitis
Version: 0 Date: 01 Jan 2024
Reviewer's report:
In this study, the authors aimed  toinvestigate the association between Microscopic colitis (MC)
and celiac disease (CD).
Overall, they studied 158 women with MC. Participants completed a study questionnaire about
sociodemographic factors, lifestyle habits, and medical history; the Rome III questionnaire; and
the visual analog scale for irritable bowel syndrome (VAS-IBS). Patients were categorized into
collagenous colitis (CC, n=92) and lymphocytic colitis (LC, n=66) or MC with one episode of
the disease (n=70) and refractory MC (n=88). Differences between groups were calculated and
logistic regression was adjusted for smoking habits.
They found that MC and CD debuted simultaneously 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).
Corticosteroid use 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). When adjusted for smoking habits, CD  was associated with LC
(OR: 4.222; p=0.047) and tended to be inversely associated with refractory MC (OR: 0.210;
p=0.058). They concluded that CD is most common in patients with one episode of LC thus
leaving open the question of whether to consider LC in combination with CD as celiac disease
or two different entities.
The study is of interest, however important issues should be addressed.
-It is unclear whether the diagnosis of celiac disease was preexisting or was established only
after MC was diagnosed. The authors should more clearly expose the study design. The criteria
used for the diagnosis of both celiac disease and MC (collagenous and lymphocytic) should also
be well defined.
It is critical in this study to clearly report the temporal relationship between the diagnoses
of celiac disease and microscopic colitis because the authors concluded that it remains to be
determined whether LC should be classified as celiac disease. However, previous literature data
have indicated microscopic colitis as a possible complication of celiac disease, both in treated
and untreated celiac disease patients.
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: 01 Jan 2024
Reviewer's report:
In this study, the authors aimed  toinvestigate the association between Microscopic colitis (MC)
and celiac disease (CD).
Overall, they studied 158 women with MC. Participants completed a study questionnaire about
sociodemographic factors, lifestyle habits, and medical history; the Rome III questionnaire; and
the visual analog scale for irritable bowel syndrome (VAS-IBS). Patients were categorized into
collagenous colitis (CC, n=92) and lymphocytic colitis (LC, n=66) or MC with one episode of
the disease (n=70) and refractory MC (n=88). Differences between groups were calculated and
logistic regression was adjusted for smoking habits.
They found that MC and CD debuted simultaneously 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).
Corticosteroid use 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). When adjusted for smoking habits, CD  was associated with LC
(OR: 4.222; p=0.047) and tended to be inversely associated with refractory MC (OR: 0.210;
p=0.058). They concluded that CD is most common in patients with one episode of LC thus
leaving open the question of whether to consider LC in combination with CD as celiac disease
or two different entities.
The study is of interest, however important issues should be addressed.
-It is unclear whether the diagnosis of celiac disease was preexisting or was established only
after MC was diagnosed. The authors should more clearly expose the study design. The criteria
used for the diagnosis of both celiac disease and MC (collagenous and lymphocytic) should also
be well defined.
It is critical in this study to clearly report the temporal relationship between the diagnoses
of celiac disease and microscopic colitis because the authors concluded that it remains to be
determined whether LC should be classified as celiac disease. However, previous literature data
have indicated microscopic colitis as a possible complication of celiac disease, both in treated
and untreated celiac disease patients.
assistant