Letter: Ulcerative colitis in the elderly.
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Biomedical subjects
Publications and source records attributed to H F Otto.
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The ultrastructural pathology of ulcerative colitis was investigated on a group of 37 colitis patients. Among the epithelial changes, the alterations of the microvilli and of the glycocalyx of the surface epithelium are quite evident. These alterations may possibly be understood as a morphological substrate of a partly impaired "mucosa block" of the surface epithelium (IgA- and "secretory piece" deficiency). Hypothetically, this partly impaired "mucosa block" is considered to be an essential pathogenetic moment of ulcerative colitis. The inflammatory infiltrate of the stratum proprium mucosae is characterized in particular by numerous lymphocytes, plasma cells and macrophages. The close topographical interrelation of these cells observed here seems to indicate a functional cooperation in the auto-immunological process, as it is discussed here in connection with ulcerative colitis.
A case of "milary" Crohn's disease in a 53-year-old woman is described. There were numerous epithlioid-cell, non-caseous serosal granulomas in the jejunal and terminal ileal regions. There were, furthermore, immediately adjoining the epithelioid-cell granulomas, granuloma-like collections of brown fat tissue, a previously undescribed coexistence.
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