Collagenous Colitis as the Presenting Feature of Biopsy-Defined Celiac Disease

Abstract

This study indicates that collagenous colitis may be the presenting clinical and pathologic feature of celiac disease. Diagnosis of collagenous colitis should lead the clinician to consider exclusion of underlying occult celiac disease.

Celiac Disease and Autoimmunity in the Gut and Elsewhere

“…[75,76] The series by Freeman showed 22.9% prevalence of CD among 35 patients with collagenous colitis. There is a clear association between CD and microscopic colitis, including both collagenous and lymphocytic colitis variants.…”

Recent advances in celiac disease

“…As far as gastrointestinal c omplic ations are c onc erned, it is important to rule out c ollagenous and lymphoc ytic c olitis [11,12] , whic h may be mistaken for non-compliance with a gluten-free diet (GFD). Eight perc ent of elderly persons in nursing homes or long-term c are c enters may have assoc iated small bowel bac terial overgrowth, manifesting with malabsorption and diarrhea-like symptoms.…”

Duodenal lymphocytosis with no or minimal enteropathy: much ado about nothing?

“…Notably, in many cases, the association appears to be exclusive of gluten sensitivity, despite the recognized association of both variants of microscopic colitis with celiac disease. [48][49][50] Interestingly, the finding of duodenal intraepithelial lymphocytosis in patients with Crohn's disease can be observed concurrent with full-blown active disease but may also precede active Crohn enteritis (Figure 7). 12 Graft versus host disease also, although uncommonly, can display prominent numbers of IELs.…”