Case Of Collagenous Gastritis Research Articles

S4319 A Case of Collagenous Gastritis: Insights into the Clinical Features and Therapeutic Considerations

S4319 A Case of Collagenous Gastritis: Insights into the Clinical Features and Therapeutic Considerations

Four cases of collagenous gastritis in children

4例男性患儿均表现为缺铁性贫血，其中2例伴有腹痛。胃镜组织活检病理诊断均符合胶原性胃炎表现，2例累及十二指肠。4例患儿均口服铁剂补铁，2例加用泼尼松口服治疗。1例患儿失访，另3例贫血症状均有改善，其中使用激素治疗的患儿胶原沉积减轻。.

S3122 Collagenous Gastritis: An Atypical Presentation of a Rare Disease

Introduction: Collagenous gastritis (CG) is a rare inflammatory condition with variable presentation defined by subepithelial deposition of collagen bands in the stomach. We report an atypical case of CG in an adult female presenting with asymptomatic iron deficiency anemia. Case Description/Methods: A 38-year-old female with iron-deficiency and hypothalamic amenorrhea presented with a one year history of microcytic anemia. She denied gastrointestinal symptoms or bleeding. Hemoglobin was 9.9 grams/deciliter, iron was 23 micrograms/deciliter, iron saturation was 6%, and ferritin was 5 nanograms/milliliter. Comprehensive metabolic panel was normal. Celiac disease panel was negative. Her only medication was a copper intrauterine device. She denied use of nonsteroidal anti-inflammatory drugs, tobacco, alcohol, or drugs. Esophagogastroduodenoscopy revealed diffusely erythematous and nodular gastric mucosa with marked friability. Colonoscopy was normal. Pathology showed collagenous gastritis with severe atrophy (Figure 1). Testing for helicobacter pylori and antiparietal cell and intrinsic factor antibodies were negative. At follow-up, she revealed occasional abdominal cramping, but otherwise remained asymptomatic. She is being treated with omeprazole 40 milligrams daily for six weeks and iron supplementation. Discussion: CG is rare inflammatory condition of unknown etiology defined histologically by subepithelial deposition of collagen bands ≥ 10 µm in the lamina propria. Adults typically present with diarrhea, often attributed to concurrent collagenous sprue or collagenous colitis, and may have coexisting autoimmune disease. Children more commonly present with abdominal pain and anemia, resulting from bleeding superficial capillaries entrapped in collagen, with inflammation typically limited to the stomach. Endoscopy characteristically reveals nodularity in the gastric body, seen in half of patients. Other findings include erythema, erosions, exudates, or normal mucosa. There are no standard therapies or surveillance recommendations, and long-term sequelae remain unclear. Our patient’s symptoms and endoscopic findings are consistent with previously described pediatric, but not adult, cases of collagenous gastritis, yielding insight into the variable clinical presentation of this rare disease. A recent review found just 60 cases of CG reported from 1989 – 2015, highlighting the importance of further reports to guide clinicians.Figure 1.: A) X ray abdomen showing dilated loops of bowel. B) CT abdomen showing contrast leakage due to gastric perforation. C) Intraoperative image of NG tube perforating gastric fundus.

S2179 Triple Treat Causing Chronic Diarrhea: A Case of Collagenous Gastritis, Collagenous Colitis, and Small Intestinal Bacterial Overgrowth

S2179 Triple Treat Causing Chronic Diarrhea: A Case of Collagenous Gastritis, Collagenous Colitis, and Small Intestinal Bacterial Overgrowth

Two cases of collagenous gastritis diagnosed during the investigation of anemia

Two cases of collagenous gastritis diagnosed during the investigation of anemia

Collagenous gastritis: A case report

Background: Collagenous gastritis is a rare disease defined histologically by the subepithelial deposition of collagen bands thicker than 10 μm and the infiltration of inflammatory mononuclear cells in the lamina propria. There are approximately 60 reported cases of collagenous gastritis in the English literature. Case report: We present a 41-year-old female patient with weight loss, postprandial abdominal discomfort, early satiety, flatulence and a change in bowel habits. Her current laboratory investigation reports showed mild sideropenic anemia. Esophagogastroduodenoscopy and corresponding histological examination showed findings, typical for collagenous gastritis. Gastric emptying scintigraphy and SPECT/CT of abdomen revealed gastroparesis. Conclusion: Collagenous gastritis is a diagnostically challenging disease and its exact etiology remains unclear. Even though collagenous gastritis is a histologic diagnosis, the combination of other key clinical and endoscopic findings should prompt consideration of this entity. No safe and effective treatment has been established. Therefore, better understanding of the disease and study of a larger number of patients will help to establish diagnostic criteria and therapeutic strategies.

Collagenous Gastritis in a Patient Treated with Venlaflaxine

Purpose: Collagenous colitis, subtype of microscopic colitis, is a diagnosis made via assessment of typically normal appearing colonic mucosa biopsies. Collagen deposition is seen in the sub-epithelial layer. Symptoms include loose, watery diarrhea; abdominal pain; weight loss; and dehydration. Although collagenous colitis is a well-known entity, etiology is still unknown with medications as possible triggers. Successful treatment and symptom resolution has been shown with corticosteroids, specifically budesonide. Case reports have documented the spread of collagenous colitis to the small bowel, however, extent to gastric mucosa is extremely rare. A 62-year-old Caucasian female presented to clinic for chronic diarrhea and moderate epigastric cramping for the past 3 months. Patient's medical history included anxiety and depression treated with venlafaxine that was started 7 months prior to presentation. Patient described the diarrhea as watery with mucus, non-bloody and occurring up to 30 times per day with intermittent epigastric discomfort. No other symptoms were reported and weight loss was not experienced. Patient denied any recent illness, antibiotic use, sick contacts or travel. Treatment with over the counter anti-diarrheal medications and prescribed oral ciprofloxacin were unsuccessful. An extensive investigation that included routine blood tests, serologic markers, stool studies, urine collection were within normal limits. An EGD and colonoscopy were performed with biopsies taken from normal appearing stomach, small and large intestine, and rectal mucosa. Samples taken from the ascending, transverse and sigmoid colon along with the rectum showed collagen deposition compatible with collagenous colitis. Surprisingly, gastric antrum samples also showed collagen deposition. The patient was treated with an oral course of budesonide, which resolved symptoms 2 weeks after initiation. Although collagenous colitis symptoms, complications and treatment options are widely reported, collagenous gastritis appears to be a rare entity. To our knowledge, few cases of collagenous gastritis have been reported in adults and children with young women being the major group associated with the disease. Even less data is available on treatment with few reported successes with corticosteroid therapy. Possible trippers include anti-depressants such as venlafaxine in our patient. Clinicians should be cognizant of collagenous gastritis to be a cause of symptoms in patients with epigastric pain or discomfort with diffuse watery diarrhea. A thorough colonoscopy and EGD with multiple biopsies of normal appearing mucosa is justified in these patients and close follow-up is mandatory as relapse of the disease state may recur.

Collagenous Gastritis in A Korean Child : A Case Report

Collagenous gastritis, a counterpart of collagenous colitis, is an extremely rare disorder. The first case of collagenous gastritis in a Korean boy in his pre-teens who had been receiving treatment for refractory iron deficiency anemia has been reported. The patient had been suffering from intermittent abdominal pain, recurrent blood-tinged vomiting and poor oral intake. The gastric endoscopy revealed diffuse cobble-stone appearance of the mucosa with easy touch bleeding throughout the stomach but no abnormalities in the esophagus, duodenum, and colon. Pathologic examination of the gastric biopsies from the antrum, body and cardia showed a subepithelial collagen deposition with entrapped dilated capillaries, moderate infiltrates of lymphoplasma cells and eosinophils of the lamina propria, and marked hypertrophy of the muscularis mucosa. The collagen deposition appeared as discontinuous bands with focally irregular extension into the deeper part of the antral mucosa. It measured up to 150 µm. Helicobacter pylori infection was not detected. The biopsies from the duodenum, esophagus and colon revealed no pathologic abnormalities.

Collagenous gastritis: a report of six cases.

Collagenous gastritis is an exceptional entity with eight cases documented to date characterized by the presence of a thick subepithelial collagen band associated with an inflammatory infiltrate of the gastric mucosa. The aim of our study was to describe the clinical and histologic characteristics of six new cases of collagenous gastritis. All cases showed a subepithelial collagen band that averaged 30 microm but often measured up to 120 microm. This finding was almost always accompanied by mixed chronic inflammation in the lamina propria and by surface epithelial damage of varying severity. Our study seems to delineate two subsets in patients with collagenous gastritis: 1) collagenous gastritis occurring in children and young adults presenting with severe anemia, a nodular pattern on endoscopy, and a disease limited to the gastric mucosa without evidence of colonic involvement, and 2) collagenous gastritis associated with collagenous colitis occurring in adult patients presenting with chronic watery diarrhea. These findings highlight the fact that subepithelial collagen deposition may be a generalized disease affecting the entire gastrointestinal tract.