Collagenous sprue diagnosed by double balloon endoscopy.
Double balloon endoscopy (DBE) is useful for diagnosing many intestinal diseases and for endoscopic procedures. We report a case of chronic diarrhea in a 58-year-old Japanese man. He was initially suspected to have malabsorption syndrome. DBE showed reduction of folds, scalloping, mucosal nodularity and granularity. Pathological examinations of biopsies from the jejunum showed severe villous atrophy with subepithelial collagen bands. These findings led to the final diagnosis of collagenous sprue (CS). With1 month of total parenteral nutrition followed by a low-gluten diet, his symptoms gradually improved. CS has never been reported before in Japan. DBE is useful for making a diagnosis of CS, and may be considered for patients who are suffering from diarrhea of unknown cause.
Division of Gastroenterology, University of Tsukuba Hospital, Tsukuba, Japan.
Yu
Y
Yamamoto
Takeshi
T
Yamada
Daisuke
D
Akutsu
Akinori
A
Sugaya
Tetsuya
T
Murashita
Kenji
K
Matsuda
Yoshiyuki
Y
Yamamoto
Ryoko
R
Kusakabe
Tsuyoshi
T
Kaneko
Hideo
H
Suzuki
Ichinosuke
I
Hyodo
Taiki
T
Sato
Norio
N
Takayashiki
Naoto
N
Murakoshi
Ken
K
Hara
Yuji
Y
Mizokami
D053704:Capsule Endoscopy; D003094:Collagen / Q000378:metabolism; D064068:Collagenous Sprue / Q000175:diagnosis* / Q000178:diet therapy / Q000628:therapy; D055050:Diet, Gluten-Free; D058582:Double-Balloon Enteroscopy; D006801:Humans; D007150:Immunohistochemistry; D007583:Jejunum / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D014057:Tomography, X-Ray Computed
D003094:Collagen
capsule endoscopy; collagenous sprue; double balloon endoscopy; low-gluten diet; subepithelial collagen band