ISSN: 2008-2258
Vol 16, No 1 (2023): Winter
Collagenous sprue: a rare cause of watery diarrhea and villous atrophy – case report
Gastroenterology and Hepatology from Bed to Bench,
,
https://doi.org/10.22037/ghfbb.v16i1.2671
Abstract
Collagenous sprue is a rare and unrecognized cause of diarrhea and weight loss, mainly affecting the duodenum and small bowel. The clinical picture often resembles that of coeliac sprue, the main differential diagnosis, albeit being refractory to gluten-free diet. The histological features are fundamentally characterized by the deposition of collagen beneath the basement membrane of gut mucosa. Treatment should be initiated as soon as the diagnosis is established, as to prevent the progression of fibrosis. We will describe the case of a 76-year-old woman with collagenous sprue, the underwent diagnostic workup, histopathological examination, and response to treatment.
Keywords:
- watery diarrhea
- malabsorption
- weight loss
- collagenous sprue
How to Cite
Fernandes, L., Machado, B., José Cruz, A., Sarmento, G., Quelhas Costa, R., Pereira, T., Scigliano, H., & Cerqueira, R. (2022). Collagenous sprue: a rare cause of watery diarrhea and villous atrophy – case report. Gastroenterology and Hepatology from Bed to Bench, 16(1). https://doi.org/10.22037/ghfbb.v16i1.2671
References
1. Freeman, H.J., Collagenous sprue. Can J Gastroenterol, 2011. 25(4): p. 189-92.
2. Rubio-Tapia, A., et al., Gluten-free diet and steroid treatment are effective therapy for most patients with collagenous sprue. Clin Gastroenterol Hepatol, 2010. 8(4): p. 344-349.e3.
3. Soendergaard, C., L.B. Riis, and O.H. Nielsen, Collagenous sprue: a coeliac disease look-alike with different treatment strategy. BMJ Case Rep, 2014. 2014.
4. Weinstein, W.M., et al., Collagenous sprue--an unrecognized type of malabsorption. N Engl J Med, 1970. 283(24): p. 1297-301.
5. Schein, J., Syndrome on non tropical sprue with hitherto undescribed lesions of the intestine. Gastroenterology, 1947. 8(4): p. 438-60.
6. Maguire, A.A., et al., Collagenous sprue: a clinicopathologic study of 12 cases. Am J Surg Pathol, 2009. 33(10): p. 1440-9.
7. Vesoulis, Z., et al., Collagenous gastritis: a case report, morphologic evaluation, and review. Mod Pathol, 2000. 13(5): p. 591-6.
8. Lan, N., et al., Comparison of clinical features, treatment, and outcomes of collagenous sprue, celiac disease, and collagenous colitis. J Gastroenterol Hepatol, 2017. 32(1): p. 120-127.
9. Freeman, H.J., Collagenous mucosal inflammatory diseases of the gastrointestinal tract. Gastroenterology, 2005. 129(1): p. 338-50.
10. Schoolmeester, J.K., et al., Increased immunoglobulin G4–positive plasma cells in collagenous sprue. Human Pathology, 2013. 44(8): p. 1624-1629.
11. Daniels, J.A., et al., Gastrointestinal tract pathology in patients with common variable immunodeficiency (CVID): a clinicopathologic study and review. Am J Surg Pathol, 2007. 31(12): p. 1800-12.
12. Joo, M., et al., Nodular lymphoid hyperplasia and histologic changes mimicking celiac disease, collagenous sprue, and lymphocytic colitis in a patient with selective IgA deficiency. Pathol Res Pract, 2009. 205(12): p. 876-80.
13. Rubio-Tapia, A., et al., Severe spruelike enteropathy associated with olmesartan. Mayo Clin Proc, 2012. 87(8): p. 732-8.
14. Gonakoti, S., S. Khullar, and A. Rajkumar, Olmesartan Associated Enteropathy: A Rare Underdiagnosed Cause of Diarrhea and Weight Loss. The American journal of case reports, 2019. 20: p. 111-116.
15. Kamal, A., et al., Angiotensin II receptor blockers and gastrointestinal adverse events of resembling sprue-like enteropathy: a systematic review. Gastroenterology Report, 2019. 7(3): p. 162-167.
16. Doe, W.F., et al., Coeliac disease, vasculitis, and cryoglobulinaemia. Gut, 1972. 13(2): p. 112-23.
17. Schreiber, F.S., et al., Collagenous duodenitis and collagenous colitis: a short clinical course as evidenced by sequential endoscopic and histologic findings. Endoscopy, 2001. 33(6): p. 555.
18. Freeman, H.J., J.E. Davis, and D.M. Myers, Complete histological resolution of collagenous sprue. Can J Gastroenterol, 2004. 18(5): p. 333-6.
19. Del Sordo, R., et al., Collagenous Sprue and Olmesartan: another pathological condition related to this drug. Dig Liver Dis, 2021.
20. Kaneko, S., et al., Severe spruelike enteropathy and collagenous colitis caused by olmesartan. BMC Gastroenterol, 2021. 21(1): p. 350.
21. Nielsen, J.A., A. Steephen, and M. Lewin, Angiotensin-II inhibitor (olmesartan)-induced collagenous sprue with resolution following discontinuation of drug. World J Gastroenterol, 2013. 19(40): p. 6928-30.
22. Sadki, A., et al., [Olmesartan therapy and enteropathy: About two cases and review of the literature]. Rev Med Interne, 2019. 40(2): p. 112-116.
2. Rubio-Tapia, A., et al., Gluten-free diet and steroid treatment are effective therapy for most patients with collagenous sprue. Clin Gastroenterol Hepatol, 2010. 8(4): p. 344-349.e3.
3. Soendergaard, C., L.B. Riis, and O.H. Nielsen, Collagenous sprue: a coeliac disease look-alike with different treatment strategy. BMJ Case Rep, 2014. 2014.
4. Weinstein, W.M., et al., Collagenous sprue--an unrecognized type of malabsorption. N Engl J Med, 1970. 283(24): p. 1297-301.
5. Schein, J., Syndrome on non tropical sprue with hitherto undescribed lesions of the intestine. Gastroenterology, 1947. 8(4): p. 438-60.
6. Maguire, A.A., et al., Collagenous sprue: a clinicopathologic study of 12 cases. Am J Surg Pathol, 2009. 33(10): p. 1440-9.
7. Vesoulis, Z., et al., Collagenous gastritis: a case report, morphologic evaluation, and review. Mod Pathol, 2000. 13(5): p. 591-6.
8. Lan, N., et al., Comparison of clinical features, treatment, and outcomes of collagenous sprue, celiac disease, and collagenous colitis. J Gastroenterol Hepatol, 2017. 32(1): p. 120-127.
9. Freeman, H.J., Collagenous mucosal inflammatory diseases of the gastrointestinal tract. Gastroenterology, 2005. 129(1): p. 338-50.
10. Schoolmeester, J.K., et al., Increased immunoglobulin G4–positive plasma cells in collagenous sprue. Human Pathology, 2013. 44(8): p. 1624-1629.
11. Daniels, J.A., et al., Gastrointestinal tract pathology in patients with common variable immunodeficiency (CVID): a clinicopathologic study and review. Am J Surg Pathol, 2007. 31(12): p. 1800-12.
12. Joo, M., et al., Nodular lymphoid hyperplasia and histologic changes mimicking celiac disease, collagenous sprue, and lymphocytic colitis in a patient with selective IgA deficiency. Pathol Res Pract, 2009. 205(12): p. 876-80.
13. Rubio-Tapia, A., et al., Severe spruelike enteropathy associated with olmesartan. Mayo Clin Proc, 2012. 87(8): p. 732-8.
14. Gonakoti, S., S. Khullar, and A. Rajkumar, Olmesartan Associated Enteropathy: A Rare Underdiagnosed Cause of Diarrhea and Weight Loss. The American journal of case reports, 2019. 20: p. 111-116.
15. Kamal, A., et al., Angiotensin II receptor blockers and gastrointestinal adverse events of resembling sprue-like enteropathy: a systematic review. Gastroenterology Report, 2019. 7(3): p. 162-167.
16. Doe, W.F., et al., Coeliac disease, vasculitis, and cryoglobulinaemia. Gut, 1972. 13(2): p. 112-23.
17. Schreiber, F.S., et al., Collagenous duodenitis and collagenous colitis: a short clinical course as evidenced by sequential endoscopic and histologic findings. Endoscopy, 2001. 33(6): p. 555.
18. Freeman, H.J., J.E. Davis, and D.M. Myers, Complete histological resolution of collagenous sprue. Can J Gastroenterol, 2004. 18(5): p. 333-6.
19. Del Sordo, R., et al., Collagenous Sprue and Olmesartan: another pathological condition related to this drug. Dig Liver Dis, 2021.
20. Kaneko, S., et al., Severe spruelike enteropathy and collagenous colitis caused by olmesartan. BMC Gastroenterol, 2021. 21(1): p. 350.
21. Nielsen, J.A., A. Steephen, and M. Lewin, Angiotensin-II inhibitor (olmesartan)-induced collagenous sprue with resolution following discontinuation of drug. World J Gastroenterol, 2013. 19(40): p. 6928-30.
22. Sadki, A., et al., [Olmesartan therapy and enteropathy: About two cases and review of the literature]. Rev Med Interne, 2019. 40(2): p. 112-116.
- Abstract Viewed: 0 times
