3221 A Rare Case of Collagenous Sprue

Abstract

INTRODUCTION: Collagenous Sprue (CS) is a rare clinicopathological malabsorptive disorder characterized by mucosal villi atrophy and sub-epithelial collagen deposition. It is very important to consider the possibility of CS in patients diagnosed with celiac disease not improving on the gluten-free diet. CASE DESCRIPTION/METHODS: We present an elderly caucasian male with clinicopathological manifestations of Collagenous Sprue, as well as the successful treatment course that he underwent. DISCUSSION: Collagenous Sprue (CS) is a rare clinicopathological malabsorptive disorder characterized by mucosal villi atrophy which was first described in 1947. Approximately 60 cases have been reported so far in the medical literature. Replacement of the crypts with subepithelial collagen deposition in the small intestine made some experts believe CS to be a histopathologic variant of celiac disease with a poorer outcome. Although it's not true in all patients, diagnosis of CS should be considered in a patient whose symptoms are not getting better despite a gluten-free diet. Unlike in celiac disease, the collagenous deposits in CS doesn't regress with a gluten-free diet. Thus far, the etiology of CS is not clearly understood and it is very essential to initiate treatment at an early stage of the sprue to prevent fibrotic progression. Multiple treatment strategies were advised in the past but there is no standard therapy.