Clinical, Endoscopic, and Histopathological Features Distinguishing Amebic Colitis from Ulcerative Colitis in a Male Cohort: A Single-Center Retrospective Study.
- 1Department of Gastroenterology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China.
- 2Department of Pathology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China.
Abstract
Purpose
Differentiating amebic colitis (AC) from ulcerative colitis (UC) remains a significant clinical challenge. A misdiagnosis can delay appropriate treatment and even trigger life-threatening complications. Therefore, this study aimed to identify specific clinical, endoscopic features and pathological differences to facilitate accurate differential diagnosis.Patients and methods
We retrospectively analyzed 13 AC patients with definitive histological trophozoite identification, all of whom were male. To minimize potential confounding by sex, we included 21 male patients with UC admitted during the same study period as the comparator group. Demographic characteristics, laboratory parameters, endoscopic patterns, and histopathological findings were compared. An exploratory two-variable Firth penalized logistic regression model (hemoglobin and lesion continuity) was fitted to 31 complete cases, with internal validation using 2000 bootstrap resamples.Results
Clinically, UC patients showed lower hemoglobin (p = 0.004) and more frequent continuous involvement (p = 0.032) compared to AC patients. Descriptively, multisegmental AC patients exhibited more severe ileocecal than distal lesions. Notably, 61.5% of AC patients were initially misdiagnosed as UC prior to definitive biopsy results. Despite a small sample size, an exploratory model integrating hemoglobin and continuity achieved an optimism-corrected AUC of 0.905 via internal bootstrap validation.Conclusion
Integrating hemoglobin and lesion continuity, alongside the inverted severity gradient, provides valuable clinical clues to distinguish AC from UC and guide targeted biopsies. Given the small sample size and lack of external validation, these exploratory findings require prospective confirmation in larger cohorts.
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BibTeX
@article{li2026clinical,
title = {{Clinical, Endoscopic, and Histopathological Features Distinguishing Amebic Colitis from Ulcerative Colitis in a Male Cohort: A Single-Center Retrospective Study.}},
author = {Xinyu Li and Kunning Zhang and Jun Lu and Xinjuan Liu and Lin Lin and Jianyu Hao and Guang Li},
journal = {Infection and drug resistance},
year = {2026},
month = oct,
doi = {10.2147/idr.s643571},
url = {https://europepmc.org/article/MED/42974491},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Clinical, Endoscopic, and Histopathological Features Distinguishing Amebic Colitis from Ulcerative Colitis in a Male Cohort: A Single-Center Retrospective Study.
AU - Xinyu Li
AU - Kunning Zhang
AU - Jun Lu
AU - Xinjuan Liu
AU - Lin Lin
AU - Jianyu Hao
AU - Guang Li
PY - 2026
DA - 2026/10/29
JO - Infection and drug resistance
DO - 10.2147/idr.s643571
UR - https://europepmc.org/article/MED/42974491
AB - Purpose Differentiating amebic colitis (AC) from ulcerative colitis (UC) remains a significant clinical challenge. A misdiagnosis can delay appropriate treatment and even trigger life-threatening complications. Therefore, this study aimed to identify specific clinical, endoscopic features and pathological differences to facilitate accurate differential diagnosis.Patients and methods We retrospectively analyzed 13 AC patients with definitive histological trophozoite identification, all of whom were male. To minimize potential confounding by sex, we included 21 male patients with UC admitted during the same study period as the comparator group. Demographic characteristics, laboratory parameters, endoscopic patterns, and histopathological findings were compared. An exploratory two-variable Firth penalized logistic regression model (hemoglobin and lesion continuity) was fitted to 31 complete cases, with internal validation using 2000 bootstrap resamples.Results Clinically, UC patients showed lower hemoglobin (p = 0.004) and more frequent continuous involvement (p = 0.032) compared to AC patients. Descriptively, multisegmental AC patients exhibited more severe ileocecal than distal lesions. Notably, 61.5% of AC patients were initially misdiagnosed as UC prior to definitive biopsy results. Despite a small sample size, an exploratory model integrating hemoglobin and continuity achieved an optimism-corrected AUC of 0.905 via internal bootstrap validation.Conclusion Integrating hemoglobin and lesion continuity, alongside the inverted severity gradient, provides valuable clinical clues to distinguish AC from UC and guide targeted biopsies. Given the small sample size and lack of external validation, these exploratory findings require prospective confirmation in larger cohorts.
SN - 1178-6973
ER -