Collagenous enterocolitis: a manifestation of gluten-sensitive enteropathy.
We report coexistent collagenous colitis and collagenous sprue in a 62-year-old woman with diarrhea. Investigations suggested malabsorption, and small intestinal biopsies demonstrated a flattened mucosa with subepithelial collagen deposition. Colonic biopsies also showed a thickened subepithelial collagen band as well as a striking lamina propria inflammatory cell infiltrate. Symptomatic remission was induced with a gluten/lactose-free diet, oral prednisone, and sulfasalazine and has been maintained with gluten restriction alone. Repeat biopsies after 2 months demonstrated restoration of normal small intestinal and colonic collagen bands; only a chronic inflammatory cell infiltrate (consistent with microscopic/lymphocytic colitis) persisted in colonic biopsies. We propose that, in this instance, collagenous enterocolitis represented a diffuse manifestation of gluten sensitivity.
McCashland
T M
TM
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-2000.
Donovan
J P
JP
Strobach
R S
RS
Linder
J
J
Quigley
E M
EM
D002446:Celiac Disease / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism; D002908:Chronic Disease; D003094:Collagen / Q000378:metabolism*; D003106:Colon / Q000378:metabolism / Q000473:pathology; D004382:Duodenitis / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D004386:Duodenum / Q000378:metabolism / Q000473:pathology; D004760:Enterocolitis / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D005260:Female; D005983:Glutens / Q000009:adverse effects*; D006801:Humans; D007579:Jejunal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D007583:Jejunum / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged
D005983:Glutens; D003094:Collagen