PRIMARY ILEAL VILLOUS ATROPHY IS OFTEN ASSOCIATED WITH MICROSCOPIC COLITIS

Three cases of apparent primary villous atrophy of the terminal ileum in women with chronic diarrhoea are reported. Eight cases have previou sly been reported in the literature. Clinical characteristics are the presence of severe chronic secretory diarrhoea with episodes of hypoka laemia combined with signs of heal malabsorption and/or efficacy of ch olestyramine. Diagnosis is based on ileoscopy and histology. An associ ation with microscopic colitis was present in the three patients and i n four cases in the literature. The pathogenesis of primary heal villo us atrophy remains unknown and may involve dysimmunity. Its associatio n with microscopic colitis may indicate a common pathogenesis or suppo rt the hypothesis that the faecal stream or bile salts play a role in the pathogenesis of microscopic colitis.