Collagenous gastritis

Colletti, Richard B.; Trainer, Thomas D.

doi:10.1016/0016-5085(89)90403-4

Cited by 90 publications

(75 citation statements)

References 8 publications

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“…The condition was first described in 1989 by Colletti and Trainer. 1,2 To date, B50 patients with collagenous gastritis have been reported in the English language literature, mainly as reports of one or two cases. [3][4][5][6][7][8][9][10][11][12][13][14][15] The two largest previous series comprised 6 and 12 patients, respectively.…”

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confidence: 99%

Collagenous gastritis: a morphologic and immunohistochemical study of 40 patients

et al. 2015

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Collagenous gastritis is a rare condition defined histologically by a superficial subepithelial collagen layer. This study further characterizes the morphologic spectrum of collagenous gastritis by evaluating a multiinstitutional series of 40 patients (26 female and 14 male). The median age at onset was 16 years (range 3-89 years), including 24 patients (60%) under age 18. Twelve patients (30%) had associated celiac disease, collagenous sprue, or collagenous colitis. Hematoxylin and eosin slides were reviewed in biopsies from all patients and tenascin, gastrin, eotaxin, and IgG4/IgG immunohistochemical stains were applied to a subset. The distribution of subepithelial collagen favored the body/fundus in pediatric patients and the antrum in adults. There were increased surface intraepithelial lymphocytes (425 lymphocytes/100 epithelial cells) in five patients. Three of these patients had associated celiac and/or collagenous sprue/colitis, while the remaining two had increased duodenal lymphocytosis without specific etiology. An eosinophil-rich pattern (430 eosinophils/high power field) was seen in 21/40 (52%) patients. Seven patients' biopsies demonstrated atrophy of the gastric corpus mucosa. Tenascin immunohistochemistry highlighted the subepithelial collagen in all 21 specimens evaluated and was a more sensitive method of collagen detection in biopsies from two patients with subtle subepithelial collagen. No increased eotaxin expression was identified in 16 specimens evaluated. One of the twenty-three biopsies tested had increased IgG4-positive cells (100/high power field) with an IgG4/IgG ratio of 55%. In summary, collagenous gastritis presents three distinct histologic patterns including a lymphocytic gastritis-like pattern, an eosinophil-rich pattern, and an atrophic pattern. Eotaxin and IgG4 were not elevated enough to implicate these pathways in the pathogenesis. Tenascin immunohistochemistry can be used as a sensitive method of collagen detection.

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Collagenous gastritis: a morphologic and immunohistochemical study of 40 patients

et al. 2015

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“…Including our two cases, the gender was slightly female dominant (males 4, females 10, unknown 2) [1,3,[5][6][7][8]. On the other hand, three reported cases of adult-type CC were all male patients, including our second case.…”

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confidence: 88%

“…CG is diagnosed by endoscopic gastric mucosal biopsy and is characterized by a subepithelial collagenous band deposit greater than 10 μm with various degrees of inflammatory cell infiltration [1,2]. The thickened collagenous bands can entrap dilated capillaries and these bands are usually identified as mixed chronic inflammation in the lamina propria and surface epithelial damage of varying severity on gastric biopsy.…”

Section: Introductionmentioning

confidence: 99%

Two Cases of Pediatric Collagenous Gastritis Each Presenting with Refractory Iron Deficiency Anemia and Chronic Diarrhea

Lee

Kim

et al. 2012

Pediatr Gastroenterol Hepatol Nutr

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Collagenous gastritis (CG) is a rare disorder that is characterized by the presence of a thick subepithelial collagen band with multiple infiltrated inflammatory cells of the gastric mucosa. CG is divided into two major subsets: first, in children and young adults presenting with severe anemia and abdominal colic pain (pediatric-type CG); and second, in adult patients with chronic watery diarrhea associated with collagenous colitis (adult-type CG). We report two cases of pediatric-type CG, each presenting with refractory anemia and chronic diarrhea. (Pediatr Gastroenterol Hepatol Nutr 2012; 15: 183∼187)

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“…Collagen deposition in gastric mucosa has rarely been described; there are four case reports to date, and no detailed pathologic descriptions or diagnostic criteria have been elucidated (13)(14)(15)(16). We describe a case of collagenous gastritis that developed in association with celiac disease and ulcerative colitis.…”

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Collagenous Gastritis: A Case Report, Morphologic Evaluation, and Review

et al. 2000

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Collagenous gastritis is rare; there are only four previous case reports. Histologic features seem to overlap with the other "collagenous enterocolitides"; however, pathologic criteria are not yet established for the diagnosis of collagenous gastritis. We describe an additional case of ostensible collagenous gastritis in a patient who initially presented with celiac sprue and subsequently developed colonic manifestations of mucosal ulcerative colitis. Endoscopic biopsies of the stomach revealed deposition of patchy, very thick bandlike subepithelial collagen in gastric antral mucosa, focal superficial epithelial degeneration, numerous intraepithelial lymphocytes, and a dense lamina propria lymphoplasmacytic infiltrate. Image analysis evaluation of gastric antral biopsies demonstrated a mean thickness of subepithelial collagen of 27.07 . Morphologic comparison was made with age-matched control groups of 10 patients who had normal gastric mucosal biopsies and 10 patients who had "chronic" gastritis, which revealed mean subepithelial collagen measures of 1.37 and 1.19 , respectively. We compared these morphologic findings with those of all previous case reports of collagenous gastritis and propose a pathologic definition based on the limited combined data. It seems that subepithelial collagen is dramatically thickened in reported cases of collagenous gastritis, with a cumulative mean measure of 36.9 . ⌱t is also apparent from this and previous reports that the thickened subepithelial collagen is accompanied by a chronic or chronic active gastritis and sometimes intraepithelial lymphocytes and surface epithelial damage. Recently described associations of lymphocytic gastritis, sprue, and lymphocytic colitis as well as collagenous and lymphocytic colitis suggest a common pathogenesis that empirically may include collagenous gastritis in the same disease spectrum. We propose that collagenous gastritis can be confidently identified by using analogous defined features of collagenous colitis: subepithelial collagen more than 10 in a patchy distribution, lamina propria lymphoplasmacytic infiltrates, intraepithelial lymphocytes, and surface epithelial damage. Collagenous gastritis also seems to have the same spectrum of associated clinical findings as collagenous colitis, including frequent coexistence of celiac sprue, watery diarrhea syndrome, and female predominance.

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Collagenous gastritis

Cited by 90 publications

References 8 publications

Collagenous gastritis: a morphologic and immunohistochemical study of 40 patients

Collagenous gastritis: a morphologic and immunohistochemical study of 40 patients

Two Cases of Pediatric Collagenous Gastritis Each Presenting with Refractory Iron Deficiency Anemia and Chronic Diarrhea

Collagenous Gastritis: A Case Report, Morphologic Evaluation, and Review

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