Pediatric Collagenous Gastritis and Colitis

Abstract

Collagenous gastritis is a rare condition in children. A small proportion of children develop features of the "'adult" phenotype at a very young age. Patients with collagenous gastritis require long-term follow-up and monitoring of their disease. Further randomized clinical trials are needed to establish an effective therapeutic strategy.

Collagenous Gastritis in Children: Incidence, Disease Course, and Associations With Autoimmunity and Inflammatory Markers

“…Although the frequencies of heredity for autoimmune diseases and autoantibody development in our cohort are relatively high, none of the patients developed any autoimmune disease during the follow-up period, which extended up to 11 years from the initial presentation. To our knowledge, in the English-language, peer-reviewed literature to date, 10 cases with development of concomitant autoimmune disease ( 22 – 24 , 26 , 31 ) among a total of 79 pediatric cases of CG have been reported ( 15 – 24 , 26 – 37 , 39 – 41 , 43 – 45 ). Therefore, despite the low rate of autoimmune comorbidities observed in the short term in our study, childhood-onset CG may still be associated with an increased long-term risk of developing these diseases.…”

“…The condition is characterized histologically by an increased subepithelial layer of collagen (conventionally defined as being >10 μm in thickness) in the gastric mucosa, together with an inflammatory cell infiltrate in the lamina propria ( 46 , 47 ). In most pediatric cases of CG, the collagenous mucosal inflammation is restricted to the stomach ( 22 – 24 , 41 ), whereas in adult-onset disease, concurrent involvement of the small bowel and/or colon is more common ( 1 , 23 , 24 , 46 , 48 ). Pediatric cases of CG generally present with severe iron deficiency anemia and/or recurrent abdominal pain ( 22 – 24 , 41 ), whereas diarrhea and malabsorption are the predominant symptoms in adults, presumably linked to the frequently observed concurrent intestinal involvement ( 32 , 46 , 49 ).…”

“…In most pediatric cases of CG, the collagenous mucosal inflammation is restricted to the stomach ( 22 – 24 , 41 ), whereas in adult-onset disease, concurrent involvement of the small bowel and/or colon is more common ( 1 , 23 , 24 , 46 , 48 ). Pediatric cases of CG generally present with severe iron deficiency anemia and/or recurrent abdominal pain ( 22 – 24 , 41 ), whereas diarrhea and malabsorption are the predominant symptoms in adults, presumably linked to the frequently observed concurrent intestinal involvement ( 32 , 46 , 49 ). Associated immune-mediated comorbidities, such as celiac disease and type 1 diabetes, have been reported in both pediatric ( 22 – 24 , 26 , 31 ) and adult ( 3 – 5 , 23 , 24 , 45 , 47 , 50 ) patients.…”

“…Pediatric cases of CG generally present with severe iron deficiency anemia and/or recurrent abdominal pain ( 22 – 24 , 41 ), whereas diarrhea and malabsorption are the predominant symptoms in adults, presumably linked to the frequently observed concurrent intestinal involvement ( 32 , 46 , 49 ). Associated immune-mediated comorbidities, such as celiac disease and type 1 diabetes, have been reported in both pediatric ( 22 – 24 , 26 , 31 ) and adult ( 3 – 5 , 23 , 24 , 45 , 47 , 50 ) patients. CG is believed to be a chronic disease, and there is currently no effective treatment ( 46 ).…”

“…The current literature on childhood-onset CG consists mainly of case reports ( 15 – 20 , 27 – 37 , 42 , 43 , 51 ), apart from 6 small case series ( 21 , 22 , 38 – 41 ) and 3 histopathologic studies with limited clinical information and follow-up data ( 23 , 24 , 45 ). Consequently, the knowledge regarding the evolution of the clinical, endoscopic, and histologic features of the disease over time is sparse.…”