Complete histological resolution of collagenous sprue.
A 65-year-old woman developed a watery diarrhea syndrome with collagenous colitis. Later, weight loss and hypoalbuminemia were documented. This prompted small bowel biopsies that showed pathological changes of collagenous sprue. An apparent treatment response to a gluten-free diet and prednisone resulted in reduced diarrhea, weight gain and normalization of serum albumin. Later repeated biopsies from multiple small and large bowel sites over a period of over three years, however, showed reversion to normal small intestinal mucosa but persistent collagenous colitis. These results indicate that collagenous inflammatory disease may be a far more extensive process in the gastrointestinal tract than is currently appreciated. Moreover, collagenous colitis may be a clinical signal that occult small intestinal disease is present. Finally, collagenous sprue may, in some instances, be a completely reversible small intestinal disorder.
Freeman
Hugh J
HJ
Department of Medicine (Gastroenterology), University of British Columbia Hospital, 2211 Wesbrook Mall, Vancouver, BC V6T 1W5, Canada. hugfree@shaw.ca
Davis
Jennifer E
JE
Myers
Danny M
DM
D000368:Aged; D001707:Biopsy, Needle; D002446:Celiac Disease / Q000473:pathology* / Q000628:therapy; D003094:Collagen; D003106:Colon / Q000473:pathology; D004386:Duodenum / Q000473:pathology; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D011241:Prednisone / Q000627:therapeutic use
D005938:Glucocorticoids; D003094:Collagen; D011241:Prednisone