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Isoldi S, Viola F, Cucchiara S, Dilillo A, Iorfida D, Testi AM, Fiorentino F, Mallardo S. Management of collagenous gastritis in children: Case series and literature review. Indian J Gastroenterol 2023:10.1007/s12664-023-01472-3. [PMID: 37971571 DOI: 10.1007/s12664-023-01472-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/10/2023] [Indexed: 11/19/2023]
Abstract
Collagenous gastritis (CG) is a rare histopathological finding on gastric biopsies in children. It is associated with abdominal pain and iron deficiency anemia, usually not respondent to oral iron supplements. The aim of this study was to describe our experience in the management of pediatric patients with CG. Moreover, we propose to review the literature on this topic. We retrospectively reviewed all pediatric patients diagnosed with CG at our centre from January 2014 to January 2019. Three pediatric patients (2 F, mean age 12.3) were diagnosed with CG during the study period. Two presented with moderate and one with severe anemia. Symptoms were abdominal pain, asthenia and headache in two and asthenia and abdominal pain in one. All underwent upper and lower gastrointestinal endoscopy. All were firstly started with oral iron supplements with no benefit, principally due to poor compliance secondary to the worsening of the epigastric pain and proton pump inhibitor resistance. Therefore, they underwent ferric carboxymaltose (FCM) infusion with good clinical and laboratory response. Patients received a mean of two infusions/year, with stable hemoglobin levels and no adverse outcomes. Our review failed to identify a consistent response to specific treatments. Considering the apparent benign nature of the disease, symptomatic and supportive treatments are advisable. Iron deficiency anemia is largely present and therapy with oral iron supplements is not always successful. In our study, FCM infusion was effective in increasing the key blood indices in patients who poorly tolerated oral supplements.
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Affiliation(s)
- Sara Isoldi
- Pediatric Gastroenterology and Hepatology Unit, Santobono-Pausilipon Children's Hospital, Via Mario Fiore, 6, Naples, Italy.
- Maternal and Child Health Department, Sapienza - University of Rome, Polo Pontino, Latina, Italy.
- Santa Maria Goretti Hospital, Latina, Italy.
| | - Franca Viola
- Maternal and Child Health Department, Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Rome, Italy
| | - Salvatore Cucchiara
- Maternal and Child Health Department, Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Rome, Italy
| | - Anna Dilillo
- Maternal and Child Health Department, Sapienza - University of Rome, Polo Pontino, Latina, Italy
| | - Donatella Iorfida
- Maternal and Child Health Department, Sapienza - University of Rome, Polo Pontino, Latina, Italy
| | - Anna Maria Testi
- Hematology, Department of Translational and Precision Medicine, Sapienza - University of Rome, Rome, Italy
| | - Francesco Fiorentino
- Pathology Unit, Sapienza - University of Rome, Polo Pontino, Santa Maria Goretti Hospital, Latina, Italy
| | - Saverio Mallardo
- Maternal and Child Health Department, Sapienza - University of Rome, Polo Pontino, Latina, Italy
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Ziaei H, Boghratian A, Sohrabi M, Zare Mehrjardi A, Zamani F. Concurrent Collagenous Gastritis and Collagenous Colitis: A Case Presentation and Review of the Literature. Middle East J Dig Dis 2022; 14:131-135. [PMID: 36619732 PMCID: PMC9489330 DOI: 10.34172/mejdd.2022.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 12/19/2021] [Indexed: 01/11/2023] Open
Abstract
Collagenous gastritis is a rare gastrointestinal condition, and its presence with collagenous colitis may be an exception. We describe a 31-year-old man with simultaneous collagenous gastritis and collagenous colitis. The patient initially presented with dyspepsia, anemia, and weight loss. Endoscopy assessment revealed irregular gastric atrophy with the normal colon. Gastric biopsies illustrated increased thickness and subepithelial collagen band.
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Affiliation(s)
- Hossein Ziaei
- Gastrointestinal and liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Boghratian
- Gastrointestinal and liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran,Department of Internal Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Masoudreza Sohrabi
- Gastrointestinal and liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zare Mehrjardi
- Department of Pathology, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Zamani
- Gastrointestinal and liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran,Corresponding Author: Farhad Zamani, MD Professor of Internal Medicine, Gastrointestinal and Liver Diseases Research Center, Firoozgar Hospital, Behafarin Ave. Valiasr Sq. Tehran, 1593747, Iran Tel:+98 21 82141633 Fax:+98 21 82141633
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Cortez N, Berzosa M, Jacobs A, Bloom M. Collagenous Gastritis: An Unusual Presentation With Tubular Shaped Stomach. J Investig Med High Impact Case Rep 2021; 8:2324709620944695. [PMID: 32720809 PMCID: PMC7388089 DOI: 10.1177/2324709620944695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Collagenous gastritis is a rare histopathologic entity that causes marked subepithelial
collagen deposition in the gastric mucosa. Clinical presentation is diverse, considering
only less than 100 cases have been reported. However, we report a unique case of isolated
collagenous gastritis in a 71-year-old female who presented with a 6-month history of
dyspepsia and 27 kg weight loss. Her endoscopic findings revealed a tubular shaped stomach
with diffuse gastric mucosal atrophy, findings that differ with previous case reports of a
cobblestone pattern. Treatment remains unclear.
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Mandaliya R, Burkart AL, DiMarino AJ, Rattan S, Cohen S. Association between common variable immunodeficiency and collagenous infiltrative disorders of the gastrointestinal tract: A series of four patients. Indian J Gastroenterol 2016; 35:133-8. [PMID: 27053352 PMCID: PMC5479432 DOI: 10.1007/s12664-016-0633-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 03/02/2016] [Indexed: 02/04/2023]
Abstract
Hypogammaglobulinemia/common variable immunodeficiency (CVID) may lead to disruption of the gut mucosal immune barrier. Collagenous infiltrative disorders of the intestinal tract (colitis, gastritis, sprue) constitute a relatively new spectrum of gastrointestinal disorders. Our aims were (1) to determine the association between immunoglobulin deficiency state like CVID and collagenous infiltrative disorders of the gut and (2) to study the clinic-pathologic characteristics and treatment outcomes in these patients. A retrospective search was conducted to identify cases with concurrence of these two conditions at an academic center from 2007 to 2013. Four such patients were identified from our database: three with collagenous colitis and one with collagenous gastritis. All patients with collagenous colitis had normal colonic mucosa while the patient with collagenous gastritis had nodular gastric mucosa. Only one patient out of four had decreased plasma cells in the submucosa as expected in low immunoglobulin states. All patients had improvement in their symptoms on immunoglobulin therapy with considerable remission on budesonide. Literature search revealed reporting of four similar patients. In conclusion, (1) the association between collagenous infiltrative disorders of the gut and CVID and its prompt response to immunoglobulins with effective maintenance with budesonide are novel findings. Our study also shows that the presence of plasma cells should not rule out the possibility of CVID. (2) In patients with chronic diarrhea, hypogammaglobulinemia and collagenous colitis/sprue should be considered for the available effective treatments such as immunoglobulins and budesonide.
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Affiliation(s)
- Rohan Mandaliya
- Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Ashlie L. Burkart
- Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Anthony J. DiMarino
- Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Satish Rattan
- Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Sidney Cohen
- Division of Gastroenterology and Hepatology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
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