Collagenous colitis in an adult patient with chronic diarrhoea: case report.
Collagenous colitis is an established cause of chronic watery diarrhoea of unknown aetiopathogenesis, characterised by normal colonic endoscopic findings, and a prominent collagen band in the sub-epithelial layer on colonic mucosal histology. We report a case of a 65-year old male who presented with recurrent episodes of watery diarrhoea of 38 years duration. There was a positive family history of similar diarrhoea in the mother and two siblings. Colonoscopy done was macroscopically unremarkable except for a redundant sigmoid colon. Mucosal biopsy of the rectum and colon showed at histology atrophy of the mucosal lining, infiltration of the lamina propria by plasma cells and lymphocytes, and a thick band of collagenous tissue in the sub-epithelial zone of the lining mucosa. A high index of suspicion is necessary to make the diagnosis in patients with chronic diarrhoea, especially when common causes of chronic diarrhoea like intestinal parasitoses, HIV/AIDS, diabetic autonomic neuropathy, thyrotoxicosis have been excluded. It is suggested that colonoscopic examination with adequate biopsy should be performed in patients with chronic diarrhoea with no aetiologic agent identified.
Otegbayo
J A
JA
Department of Medicine, University College Hospital, Ibadan, Nigeria.
Oluwasola
A O
AO
Akang
E E
EE
D000368:Aged; D003092:Colitis / Q000150:complications* / Q000473:pathology; D003106:Colon / Q000473:pathology*; D003967:Diarrhea / Q000209:etiology* / Q000473:pathology; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male