title: Clinical and histological resolution of collagenous sprue following gluten-free diet and discontinuation of non-steroidal anti-inflammatory drugs (NSAIDs).
abstract: Collagenous sprue is a rare small bowel enteropathy that has overlapping clinical features with coeliac disease; it is commonly associated with arthritic autoimmune conditions, which often require non-steroidal anti-inflammatory drugs (NSAIDs). In the limited published literature available, there are putative suggestions of a link between NSAID use and collagen deposition in intestinal subepithelia in such patients. The authors present a case of a 43-year-old woman with long-standing NSAID use for autoimmune polyarthropathy and positive coeliac antibodies. However, distal duodenal biopsies revealed a thickened band of subepithelial collagen with villous atrophic appearances consistent with collagenous sprue. The patient was treated with a gluten-free diet and her NSAIDs were discontinued. After 6 months, her gastrointestinal symptoms had resolved with complete histological resolution of the collagenous subepithelial bands and villous atrophy on duodenal biopsy.
authors.affiliation: Department of Gastroenterology, Faculty of Medical and Human Sciences, Salford Royal Foundation Trust, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK. dipesh.vasant@manchester.ac.uk
authors.forename: D H
authors.initials: DH
authors.lastname: Vasant
authors.forename: S
authors.initials: S
authors.lastname: Hayes
authors.forename: R
authors.initials: R
authors.lastname: Bucknall
authors.forename: S
authors.initials: S
authors.lastname: Lal
mesh_terms: D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D064068:Collagenous Sprue / Q000178:diet therapy* / Q000473:pathology; D055050:Diet, Gluten-Free; D004386:Duodenum / Q000473:pathology*; D005260:Female; D006801:Humans; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal