Allergic colitis differential diagnosis: Difference between revisions

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{{Allergic colitis}}
{{Allergic colitis}}
{{CMG}}; {{AE}}{{QS}}
{{CMG}}; {{AE}}{{QS}}
==Overview==
==Overview==
Symptoms and signs of allergic colitis are non-specific and seen in other causes of colitis and some systemic diseases. Detailed history and physical examination is needed to make the diagnosis. In addition, endoscopy with biopsy may be required to confirm the diagnosis. In infancy, allergic colitis must particularly be differentiated from necrotizing enterocolitis, infectious colitis, anal fissure, intussusception and volvolus. In adolescent and adults, allergic colitis must be differentiated from inflammatory bowel disease, infectious colitis, and colorectal malignancy.<ref name="pmid21922029">{{cite journal| author=Alfadda AA, Storr MA, Shaffer EA| title=Eosinophilic colitis: epidemiology, clinical features, and current management. | journal=Therap Adv Gastroenterol | year= 2011 | volume= 4 | issue= 5 | pages= 301-9 | pmid=21922029 | doi=10.1177/1756283X10392443 | pmc=3165205 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21922029  }} </ref><ref name="pmid10634300">{{cite journal| author=Lake AM| title=Food-induced eosinophilic proctocolitis. | journal=J Pediatr Gastroenterol Nutr | year= 2000 | volume= 30 Suppl | issue=  | pages= S58-60 | pmid=10634300 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10634300  }} </ref>
Symptoms and signs of allergic colitis are non-specific and observed in other causes of colitis and some systemic diseases. Detailed history and physical examination is needed to make the diagnosis. In addition, [[endoscopy]] with biopsy may be required to confirm the diagnosis. In infancy, allergic colitis must particularly be differentiated from [[necrotizing enterocolitis]], [[infectious colitis]], [[anal fissure]], [[intussusception]], and [[volvulus]]. In adolescent and adults, allergic colitis must be differentiated from [[inflammatory bowel disease]], [[infectious colitis]], and colorectal malignancy.


==Differentiating Allergic colitis from other Diseases==
==Differentiating Allergic Colitis from Other Diseases==
The differential diagnosis of allergic colitis can be classified into two according to age group.
The differential diagnosis of allergic colitis can be classified into two according to age group.
===Differential diagnosis in Infants===
 
===Differential Diagnosis in Infants===
*[[Swallowed maternal blood syndrome]]
*[[Swallowed maternal blood syndrome]]
*[[Anorectal fissure]]
*[[Anorectal fissure]]
*[[Necrotizing enterocolitis]] especially in preterm babies
*[[Necrotizing enterocolitis]] especially in preterm babies
*[[Vitamin K deficiency hemorrhage]]
*[[Vitamin K deficiency hemorrhage]]
*Other Coagulopathies (hereditary such as coagulation factor deficiency or acquired such as [[Liver disease]] with clotting factor deficiency)  
*Other coagulopathies (hereditary such as coagulation factor deficiency or acquired such as [[liver disease]] with clotting factor deficiency)  
*[[Intussusception]]
*[[Intussusception]]
*Infectious colitis
*[[Infectious colitis]]
*[[Hirschsprung disease]] complicated by enterocolitis
*[[Hirschsprung disease]] complicated by enterocolitis
*[[Volvolus]]
*[[Volvulus]]
*Inflammatory bowel disease(early onset)
*[[Inflammatory bowel disease]] (early onset)
*[[Meckel diverticulum]]
*[[Meckel diverticulum]]
*Dermatitis
*[[Dermatitis]]
*Gastrointestinal duplication cyst
*Gastrointestinal duplication cyst
*Vascular malformations
*Vascular malformations
Line 25: Line 27:
*Lymphonodular hyperplasia
*Lymphonodular hyperplasia


===Differential diagnosis in adolescent/ adult===
===Differential Ddiagnosis in Adolescent/Adult===
*Inflammatory bowel disease
*[[Inflammatory bowel disease]]
*Behcet's disease
*[[Behcet's disease]]
*Arteriovenous malformation
*[[Arteriovenous malformation]]
*Diverticulosis
*[[Diverticulosis]]
*Infectious colitis
*[[Infectious colitis]]
*Coagulopathy
*[[Coagulopathy]]
*[[Henoch-Schonlein purpura]]
*[[Henoch-Schonlein purpura]]
*Systemic lupus erythematosus(SLE)
*[[Systemic lupus erythematosus]] (SLE)
*Colorectal malignancy
*Colorectal malignancy
*The symptoms of colitis, such as [[diarrhea]] (especially bloody diarrhea and [[abdominal pain]])) are observed in all forms of colitis. The table below lists the differential diagnosis of common causes of colitis:<ref name="pmid14702426">{{cite journal| author=Thielman NM, Guerrant RL| title=Clinical practice. Acute infectious diarrhea. | journal=N Engl J Med | year= 2004 | volume= 350 | issue= 1 | pages= 38-47 | pmid=14702426 | doi=10.1056/NEJMcp031534 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14702426  }} </ref><ref name="pmid15537721">{{cite journal| author=Khan AM, Faruque AS, Hossain MS, Sattar S, Fuchs GJ, Salam MA| title=Plesiomonas shigelloides-associated diarrhoea in Bangladeshi children: a hospital-based surveillance study. | journal=J Trop Pediatr | year= 2004 | volume= 50 | issue= 6 | pages= 354-6 | pmid=15537721 | doi=10.1093/tropej/50.6.354 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15537721  }} </ref>
{|
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
! rowspan="2" |Diseases
! colspan="4" |History and Symptoms
! colspan="4" |Physical Examination
! colspan="4" |Laboratory findings
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
!Diarrhea
!Rectal bleeding
!Abdominal pain
!Atopy
!Dehydration
!Fever
!Hypotension
!Malnutrition
!Blood in stool (frank or occult)
!Microorganism in stool
!Pseudomembranes on endoscopy
!Lab Test 4
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Allergic Colitis
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Chemical colitis
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Infectious colitis
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | +++
| style="background: #F5F5F5; padding: 5px;" | +++
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Radiation colitis
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Ischemic colitis
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Drug-induced colitis
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | ++
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" | +
| style="background: #F5F5F5; padding: 5px;" |
|}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Gastroenterology]]
[[Category:InfectiousDisease]]
[[Category:PrimaryCare]]
{{WS}}{{WH}}

Latest revision as of 15:43, 1 February 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Qasim Salau, M.B.B.S., FMCPaed [2]

Overview

Symptoms and signs of allergic colitis are non-specific and observed in other causes of colitis and some systemic diseases. Detailed history and physical examination is needed to make the diagnosis. In addition, endoscopy with biopsy may be required to confirm the diagnosis. In infancy, allergic colitis must particularly be differentiated from necrotizing enterocolitis, infectious colitis, anal fissure, intussusception, and volvulus. In adolescent and adults, allergic colitis must be differentiated from inflammatory bowel disease, infectious colitis, and colorectal malignancy.

Differentiating Allergic Colitis from Other Diseases

The differential diagnosis of allergic colitis can be classified into two according to age group.

Differential Diagnosis in Infants

Differential Ddiagnosis in Adolescent/Adult

  • The symptoms of colitis, such as diarrhea (especially bloody diarrhea and abdominal pain)) are observed in all forms of colitis. The table below lists the differential diagnosis of common causes of colitis:[1][2]
Diseases History and Symptoms Physical Examination Laboratory findings
Diarrhea Rectal bleeding Abdominal pain Atopy Dehydration Fever Hypotension Malnutrition Blood in stool (frank or occult) Microorganism in stool Pseudomembranes on endoscopy Lab Test 4
Allergic Colitis + ++ + ++ ++
Chemical colitis + ++ ++ + + ++ +
Infectious colitis ++ ++ ++ +++ +++ ++ + ++ ++ +
Radiation colitis + ++ + + + ++
Ischemic colitis + + ++ + + + + ++
Drug-induced colitis + + ++ + ++ +

References

  1. ↑ Thielman NM, Guerrant RL (2004). "Clinical practice. Acute infectious diarrhea". N Engl J Med. 350 (1): 38–47. doi:10.1056/NEJMcp031534. PMID 14702426.
  2. ↑ Khan AM, Faruque AS, Hossain MS, Sattar S, Fuchs GJ, Salam MA (2004). "Plesiomonas shigelloides-associated diarrhoea in Bangladeshi children: a hospital-based surveillance study". J Trop Pediatr. 50 (6): 354–6. doi:10.1093/tropej/50.6.354. PMID 15537721.
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