Collagenous Gastritis

Abstract

A 54-year-old woman presented with nausea, vomiting and weight loss associated with impaired gastric emptying necessitating institution of parenteral nutrition. Subsequent studies revealed an unusual gastric mucosa! inflammatory nrocess characterized by unique subepithelial collagenous deposits. Collagenous gastritis appears to be a distinct, possibly immune-mediated, chronic disorder, pathologically reminiscent of collagenous sprue and collagenous colitis.Can J Gastroenterol 1989;3(5): [171][172][173][174] Key Words: Collagenous colitis, Collagenous sprue, Gastric histology, Gastritis Gastrite collagenique RESUME: Une patiente de 54 ans presente des nausees, des vomissements et une perte de poids lies a une deterioration de la vidange gastrique necessitant !'institution d'une alimentation parenterale. Des etudes subsequentes revelent un processus inflammatoire inhabituel de la muqueuse gastrique caracterise par des depots sous-cpitheliaux de collagene. La gastrite collagenique semble e tre une affection chronique distincte, peut-etre d 'origine immunitaire, dont la pathologie rappelle celle de la sprue collagenique et de la colite collagenique. I N 1970, WEINSTEIN ET AL ( I ) DESCRIBEDa unique form of sprue -collagenous sprue -characterized clinically by refractory malabsorption and histopathologically by subepithelial collagen deposition in small in testinal biopsies. Simila r histological features in the small intestine were noted in two earlier reports by Schein (2) and Hourihane (3). ln 1976. two reports independently described previously unrecognized histopathological featu res in colorectal biopsies from patients with chronic watery diarrhea ( 4 ,5 ). Thick subepi thelial collagenous de- Medicine (Gastroemerology) posi ts were seen and Lindstrom (5), in one of these reports, proposed the label collagenous colitis because of apparent pathological similarities to collagenous sprue. Since 1976, more than 50 patients with this disorder have been described and reviewed; in at least one patient both the small and large bowel were involved with the same process (7). In the present report, a 54-year-old woman with a distinct form of gastri tis is described. Clinical fea tures suggested a progressive, possibly immune-mediated disorder, while gastri c biopsies were cha racte rized histopathologicall y by trichrome-positive, subepithelial collagenous deposits reminiscent of previously described changes in the small and large intestine of patients with collagenous sprue or collagenous colitis ( 1-7). Departments of CASE PRESENTATIONA 54-year-old woman born in Scotland was initially seen in March 1979 with a three year history of anorexia, intermittent vomiting and weight loss of 14 kg. She d id not use alcohol, salicylates or other medications. Past history included a psychiatric admission in 1972 fo r depression; at that time, nausea and vomiting were apparently present. Examination revealed a weight of 38 kg and generalized muscle wasting. Gastroscopy FREEMAN et al Figure 1) Gastric biopsy showing a dense...

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

“…[17][18][19] The patient with collagenous gastritis reported here also had topographic mapping and electron microscopic studies of gastric mucosal biopsies with results previously reported elsewhere. 19…”

Collagenous gastritis: a morphologic and immunohistochemical study of 40 patients

“…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. 16,17 On the basis of patient age and clinical presentation, Lagorce-Pages et al 16 recognized two general clinical subgroups in collagenous gastritis.…”

Collagenous Gastritis: Endoscopic and Pathologic Evaluation of the Nodularity of Gastric Mucosa

“…Collagenous gastritis is an extremely rare clinicopathological entity, with 20 cases reported in the English literature to date from the United States, Germany, Canada, France, Spain, India, Japan, and Korea [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15].…”

“…Collagenous gastritis is a rare disorder, with 20 cases reported in the English literature to date [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15]; the pathogenesis and prognosis remain unknown. Collagenous gastritis is defined histologically by the presence of a subepithelial collagen band thicker than 10 µm in association with increased inflammatory cell infiltrate of the lamina propria [9] and it is therefore straightforward to make a histological diagnosis from a biopsy specimen.…”