{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T03:00:54Z","timestamp":1777086054878,"version":"3.51.4"},"reference-count":50,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T00:00:00Z","timestamp":1677456000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Inflammatory bowel diseases (Crohn\u2019s disease and ulcerative colitis) and microscopic colitis (lymphocytic and collagenous colitis) are immune-mediated diseases of the gastrointestinal tract, with distinct pathophysiology. Objective: We sought to compare the prevalence of autoimmune diseases between microscopic colitis (MC) and inflammatory bowel diseases (IBDs) in our patient cohorts in their medical history. Methods: We collected data from 611 patients (508 with IBD, 103 with MC). We recorded cases of other autoimmune diseases. The screened documentation was written in the period between 2008 and 2022. We sought to determine whether colonic involvement had an impact on the prevalence of autoimmune diseases. Results: Ulcerative colitis patients and patients with colonic-predominant Crohn\u2019s disease had a greater propensity for autoimmune conditions across the disease course than patients with ileal-predominant Crohn\u2019s disease. Gluten-related disorders were more common in Crohn\u2019s disease than in ulcerative colitis, and slightly more common than in microscopic colitis. In ulcerative colitis, 10 patients had non-differentiated collagenosis registered, which can later develop into a definite autoimmune disease. Conclusions: Predominantly colonic involvement can be a predisposing factor for developing additional autoimmune disorders in IBD. Ulcerative colitis patients may have laboratory markers of autoimmunity, without fulfilling the diagnostic criteria for definitive autoimmune disorders (non-differentiated collagenosis).<\/jats:p>","DOI":"10.3390\/life13030652","type":"journal-article","created":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T04:05:40Z","timestamp":1677470740000},"page":"652","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Contrasting Autoimmune Comorbidities in Microscopic Colitis and Inflammatory Bowel Diseases"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4368-7709","authenticated-orcid":false,"given":"Istvan","family":"Fedor","sequence":"first","affiliation":[{"name":"Department of Public Health and Epidemiology, Faculty of Medicine, University of Debrecen, Kassai Street 26, 4012 Debrecen, Hungary"},{"name":"Department of Clinical Immunology, Faculty of Medicine, Institute of Internal Medicine, Doctoral School of Clinical Immunology and Allergology, University of Debrecen, Moricz Zs. Street 22, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3212-6877","authenticated-orcid":false,"given":"Eva","family":"Zold","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology, Faculty of Medicine, Institute of Internal Medicine, Doctoral School of Clinical Immunology and Allergology, University of Debrecen, Moricz Zs. Street 22, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8200-6937","authenticated-orcid":false,"given":"Zsolt","family":"Barta","sequence":"additional","affiliation":[{"name":"GI Unit, Department of Infectology, Faculty of Medicine, Doctoral School of Clinical Immunology and Allergology, University of Debrecen, Bartok Bela Street 2-26, 4031 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1038\/s41572-021-00273-2","article-title":"Microscopic colitis","volume":"7","author":"Burke","year":"2021","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1038\/s41572-020-0156-2","article-title":"Crohn\u2019s disease","volume":"6","author":"Roda","year":"2020","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1038\/s41572-020-0205-x","article-title":"Ulcerative colitis","volume":"6","author":"Kobayashi","year":"2020","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_4","first-page":"309","article-title":"The gut and the Inflammatory Bowel Diseases inside-out: The extra-intestinal manifestations","volume":"65","author":"Ribaldone","year":"2019","journal-title":"Minerva Gastroenterol. Dietol."},{"key":"ref_5","first-page":"19","article-title":"Microscopic colitis is associated with several concomitant diseases","volume":"2013","author":"Roth","year":"2013","journal-title":"Drug Target Insights"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/0016-5085(95)90332-1","article-title":"Collagenous Colitis and Fecal Stream Diversion","volume":"109","author":"Tysk","year":"1995","journal-title":"Gastroenterology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1136\/gut.2004.058750","article-title":"Dynamics of mucosal permeability and inflammation in collagenous colitis before, during, and after loop ileostomy","volume":"54","author":"Wallon","year":"2005","journal-title":"Gut"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1080\/00365521.2020.1839544","article-title":"Faecal microbiota transfer in patients with microscopic colitis\u2013a pilot study in collagenous colitis","volume":"55","author":"Holster","year":"2020","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1111\/jgh.15731","article-title":"An update on fecal microbiota transplantation for the treatment of gastrointestinal diseases","volume":"37","author":"Waller","year":"2022","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e87","DOI":"10.14309\/crj.2017.87","article-title":"Microscopic Colitis After Fecal Microbiota Transplant","volume":"4","author":"Fasullo","year":"2017","journal-title":"ACG Case Rep. J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1080\/07853890.2021.1962965","article-title":"Microscopic colitis: Controversies in clinical symptoms and autoimmune comorbidities","volume":"53","author":"Fedor","year":"2021","journal-title":"Ann. Med."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Fedor, I., Zold, E., and Barta, Z. (2021). Temporal relationship of extraintestinal manifestations in inflammatory bowel disease. J. Clin. Med., 10.","DOI":"10.3390\/jcm10245984"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3661","DOI":"10.1002\/sim.2832","article-title":"Chi-squared and Fisher\u2013Irwin tests of two-by-two tables with small sample recommendations","volume":"26","author":"Campbell","year":"2007","journal-title":"Stat. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1556\/OH.2009.28610","article-title":"Undifferentiated connective tissue disease","volume":"150","author":"Bodolay","year":"2009","journal-title":"Orv. Hetil."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1956","DOI":"10.3748\/wjg.v21.i6.1956","article-title":"Distinctive inflammatory bowel disease phenotype in primary sclerosing cholangitis","volume":"21","author":"Janse","year":"2015","journal-title":"World J. Gastroenterol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S1333","DOI":"10.14309\/01.ajg.0000786468.70739.c8","article-title":"S3234 The Association of Microscopic Colitis and Primary Sclerosing Cholangitis","volume":"116","author":"Sehgal","year":"2021","journal-title":"Am. Coll. Gastroenterol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"398","DOI":"10.4997\/jrcpe.2020.409","article-title":"Retrospective studies\u2014Utility and caveats","volume":"50","author":"Talari","year":"2020","journal-title":"J. R. Coll. Physicians Edinb."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/j.therap.2018.11.001","article-title":"The limitations of observation studies for decision making regarding drugs efficacy and safety","volume":"74","author":"Gueyffier","year":"2019","journal-title":"Therapies"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1111\/apt.13940","article-title":"The impact of co-existing immune-mediated diseases on phenotype and outcomes in inflammatory bowel diseases","volume":"45","author":"Conway","year":"2017","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1093\/ecco-jcc\/jjz152","article-title":"Global Prevalence and Bidirectional Association between Psoriasis and Inflammatory Bowel Disease-A Systematic Review and Meta-analysis","volume":"14","author":"Alinaghi","year":"2020","journal-title":"J. Crohns Colitis"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"916645","DOI":"10.3389\/fimmu.2022.916645","article-title":"Causal Association Between Inflammatory Bowel Disease and Psoriasis: A Two-Sample Bidirectional Mendelian Randomization Study","volume":"13","author":"Li","year":"2022","journal-title":"Front. Immunol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1136\/annrheumdis-2018-214273","article-title":"Incidence rates of inflammatory bowel disease in patients with psoriasis, psoriatic arthritis and ankylosing spondylitis treated with secukinumab: A retrospective analysis of pooled data from 21 clinical trials","volume":"78","author":"Schreiber","year":"2019","journal-title":"Ann. Rheum. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"9404505","DOI":"10.1155\/2020\/9404505","article-title":"Secukinumab-Induced Inflammatory Bowel Disease in a Patient Treated for Chronic Plaque Psoriasis and Psoriatic Arthritis: A Case Report and Review of the Role of Novel Biologic Agents Targeting the p19 Subunit of IL-23","volume":"2020","author":"Darch","year":"2020","journal-title":"Case Rep. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"5233","DOI":"10.1093\/rheumatology\/keab193","article-title":"Secukinumab as a potential trigger of inflammatory bowel disease in ankylosing spondylitis or psoriatic arthritis patients","volume":"60","author":"Onac","year":"2021","journal-title":"Rheumatology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2634","DOI":"10.1016\/j.cgh.2019.04.040","article-title":"Should We Divide Crohn\u2019s Disease Into Ileum-Dominant and Isolated Colonic Diseases?","volume":"17","author":"Dulai","year":"2019","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1097\/MIB.0000000000001150","article-title":"Colonic Phenotypes Are Associated with Poorer Response to Anti-TNF Therapies in Patients with IBD","volume":"23","author":"Yoon","year":"2017","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"151992","DOI":"10.1016\/j.semarthrit.2022.151992","article-title":"Rheumatoid arthritis and inflammatory bowel disease: A bidirectional two-sample Mendelian randomization study","volume":"55","author":"Meisinger","year":"2022","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e001558","DOI":"10.1136\/rmdopen-2020-001558","article-title":"The arthritis connection to inflammatory bowel disease (IBD): Why has it taken so long to understand it?","volume":"7","author":"Ashrafi","year":"2021","journal-title":"RMD Open"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Chen, Y., Chen, L., Xing, C., Deng, G., Zeng, F., Xie, T., Gu, L., and Yang, H. (2020). The risk of rheumatoid arthritis among patients with inflammatory bowel disease: A systematic review and meta-analysis. BMC Gastroenterol., 20.","DOI":"10.1186\/s12876-020-01339-3"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1901274","DOI":"10.1002\/mnfr.201901274","article-title":"Gluten-Free Diet in IBD: Time for a Recommendation?","volume":"65","author":"Weaver","year":"2021","journal-title":"Mol. Nutr. Food Res."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Passali, M., Josefsen, K., Frederiksen, J.L., and Antvorskov, J.C. (2020). Current evidence on the efficacy of gluten-free diets in multiple sclerosis, psoriasis, type 1 diabetes and autoimmune thyroid diseases. Nutrients, 12.","DOI":"10.3390\/nu12082316"},{"key":"ref_32","first-page":"16","article-title":"Pathophysiology of non-celiac gluten sensitivity: Where are we now?","volume":"63","author":"Caio","year":"2017","journal-title":"Minerva Gastroenterol. Dietol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"6","DOI":"10.3389\/fnut.2020.00006","article-title":"Pathogenesis of Celiac Disease and Other Gluten Related Disorders in Wheat and Strategies for Mitigating Them","volume":"7","author":"Sharma","year":"2020","journal-title":"Front. Nutr."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"C\u00e1rdenas-Torres, F.I., Cabrera-Ch\u00e1vez, F., Figueroa-Salcido, O.G., and Ontiveros, N. (2021). Non-celiac gluten sensitivity: An update. Medicina, 57.","DOI":"10.3390\/medicina57060526"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"9151525","DOI":"10.1155\/2021\/9151525","article-title":"The Epidemiology of Primary Biliary Cholangitis in European Countries: A Systematic Review and Meta-Analysis","volume":"2021","author":"Gazda","year":"2021","journal-title":"Can. J. Gastroenterol. Hepatol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1097\/MCG.0000000000001449","article-title":"Epidemiology of Autoimmune Hepatitis (AIH) in the United States Between 2014 and 2019: A Population-based National Study","volume":"55","author":"Tunio","year":"2021","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3183","DOI":"10.3389\/fimmu.2018.03183","article-title":"The role of dietary nutrients in inflammatory bowel disease","volume":"10","author":"Sugihara","year":"2019","journal-title":"Front. Immunol."},{"key":"ref_38","first-page":"CD007348","article-title":"Glutamine for induction of remission in Crohn\u2019s disease","volume":"2016","author":"Akobeng","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.clnesp.2020.12.023","article-title":"Effects of glutamine supplementation on inflammatory bowel disease: A systematic review of clinical trials","volume":"42","author":"Severo","year":"2021","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.3389\/fimmu.2020.01823","article-title":"Psychological Stress, Intestinal Barrier Dysfunctions, and Autoimmune Disorders: An Overview","volume":"11","author":"Menard","year":"2020","journal-title":"Front. Immunol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1007\/s12016-011-8291-x","article-title":"Leaky Gut and Autoimmune Diseases","volume":"42","author":"Fasano","year":"2012","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_42","first-page":"152428","article-title":"Autoimmunity and the gut","volume":"2014","author":"Campbell","year":"2014","journal-title":"Autoimmune Dis."},{"key":"ref_43","first-page":"hzx015","article-title":"Intestinal permeability and autoimmune diseases","volume":"10","author":"Smyth","year":"2017","journal-title":"Biosci. Horiz. Int. J. Stud. Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"673708","DOI":"10.3389\/fimmu.2021.673708","article-title":"Partners in Leaky Gut Syndrome: Intestinal Dysbiosis and Autoimmunity","volume":"12","author":"Kinashi","year":"2021","journal-title":"Front. Immunol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2388","DOI":"10.1001\/jama.2018.7028","article-title":"Association of stress-related disorders with subsequent autoimmune disease","volume":"319","author":"Song","year":"2018","journal-title":"JAMA\u2014J. Am. Med. Assoc."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"707543","DOI":"10.3389\/fpsyt.2021.707543","article-title":"The Relationship Between Inflammation and Post-traumatic Stress Disorder","volume":"12","author":"Sun","year":"2021","journal-title":"Front. Psychiatry"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Bookwalter, D.B., Roenfeldt, K.A., Leardmann, C.A., Kong, S.Y., Riddle, M.S., and Rull, R.P. (2020). Posttraumatic stress disorder and risk of selected autoimmune diseases among US military personnel. BMC Psychiatry, 20.","DOI":"10.1186\/s12888-020-2432-9"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1136\/flgastro-2019-101323","article-title":"Inflammatory bowel disease psychological support pilot reduces inflammatory bowel disease symptoms and improves psychological wellbeing","volume":"12","author":"Eccles","year":"2021","journal-title":"Frontline Gastroenterol."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Timmer, A., Preiss, J.C., Motschall, E., R\u00fccker, G., Jantschek, G., and Moser, G. (2011). Psychological interventions for treatment of inflammatory bowel disease. Cochrane Database Syst. Rev.","DOI":"10.1002\/14651858.CD006913.pub2"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1093\/ecco-jcc\/jjv193","article-title":"Inflammatory bowel disease and the risk of autoimmune diseases","volume":"10","author":"Furlano","year":"2016","journal-title":"J. Crohns Colitis"}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/3\/652\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:43:23Z","timestamp":1760121803000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/3\/652"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,27]]},"references-count":50,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["life13030652"],"URL":"https:\/\/doi.org\/10.3390\/life13030652","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,27]]}}}