Subject(s)
Collagenous Sprue/diagnosis , Intestinal Mucosa/pathology , Adrenal Cortex Hormones/therapeutic use , Collagen/chemistry , Collagenous Sprue/complications , Collagenous Sprue/therapy , Colonoscopy , Diarrhea/complications , Diet, Gluten-Free , Endoscopy , Fatal Outcome , Hospitalization , Humans , Immunoglobulin A/immunology , Male , Middle Aged , Neuroendocrine Tumors/diagnosis , Smoking/adverse effects , Tomography, X-Ray Computed , Treatment Outcome , UltrasonographyABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Olmesartan Medoxomil/adverse effects , Antibodies, Antinuclear/analysis , Celiac Disease/chemically induced , Atrophy/chemically induced , Diarrhea/chemically induced , Duodenal Diseases/chemically induced , Methylprednisolone/therapeutic use , Diagnosis, Differential , Collagenous Sprue/complications , Collagenous Sprue/pathology , Endoscopy, Digestive System/instrumentation , Endoscopy, Digestive System/methods , Weight Loss , HLA-DQ Antigens/analysis , Immunohistochemistry/methods , CD4 Antigens/analysisABSTRACT
A 56-year-old Caucasian woman presented with epigastric pain, watery diarrhoea, bloating and flatulence following treatment with duloxetine and venlafaxine for anxiety and depression. Abdominal examination was benign. Blood work revealed haemoglobin of 96â g/L (115-160â g/L), iron 6â µmol/L (10-33â µmol/L), transferrin saturation 0.08 (0.20-0.55), ferritin 26â µg/L (15-180â µg/L), albumin 46â g/L (35-50â g/L), pre-albumin 293â mg/L (170-370â mg/L), total IgA 2.64â g/L (0.78-3.58â g/L) and anti-tTG IgA 5â units (<20â units). Faecal occult blood tests were 3/3 positive and stool cultures were negative. CT enterography was normal. Colonic biopsy revealed collagenous colitis, while duodenal biopsy showed collagenous sprue with blunted to completely flattened villi and markedly thickened subepithelial collagen table entrapping capillaries and lymphocytes. The patient started a gluten-free diet, loperamide and ferrous gluconate. Her symptoms resolved and a faecal immunochemical test performed 6â months later was negative.
Subject(s)
Anemia, Iron-Deficiency/diagnosis , Colitis, Collagenous/diagnosis , Collagen/metabolism , Collagenous Sprue/diagnosis , Diarrhea/diagnosis , Enterocolitis/diagnosis , Intestinal Mucosa/pathology , Anemia, Iron-Deficiency/etiology , Biopsy , Colitis, Collagenous/complications , Colitis, Collagenous/diet therapy , Colitis, Collagenous/pathology , Collagenous Sprue/complications , Collagenous Sprue/diet therapy , Collagenous Sprue/pathology , Colon/pathology , Diarrhea/etiology , Diet, Gluten-Free , Duodenum/pathology , Enterocolitis/complications , Enterocolitis/diet therapy , Enterocolitis/pathology , Female , Humans , Middle AgedABSTRACT
No disponible
Subject(s)
Humans , Male , Female , Atrophy/complications , Diarrhea/complications , Diarrhea/diagnosis , Diet, Gluten-Free , Celiac Disease/diagnosis , Celiac Disease/etiology , Collagenous Sprue/complications , Collagenous Sprue/diagnosis , Collagenous Sprue/drug therapy , Adrenal Cortex Hormones/therapeutic use , Immunohistochemistry , Flow Cytometry , Diagnosis, Differential , Celiac Disease/chemically induced , Celiac Disease/physiopathology , Malabsorption Syndromes/complications , Duodenal Diseases/complications , Duodenal Diseases/diagnosis , Duodenum , Duodenum/pathologyABSTRACT
Collagenous sprue is a rare disease of the small bowel characterized by mucosal atrophy and excessive subepithelial collagen deposition. The etiology remains unclear and the diagnosis is based upon patient´s clinical picture and anatomopathological findings. Clinically, collagenous sprue is characterized by persistent diarrhoea, severe malabsorption, multiple nutrient deficiencies and progressive weight loss. Differential diagnosis includes celiac disease, which is mandatory to rule out because of their frequent association. Glutenfree diet is the first therapeutic step, but it usually is not effective. However, recent studies show high success rates with immunomodulators, mainly corticosteroids. We report the case of a patient presenting with chronic diarrhea and severe malabsorption who was diagnosed with collagenous sprue, with no response to gluten free diet, but with excellent response to budesonida.
