Otegbayo J A, Oluwasola A O, Akang E E
Department of Medicine, University College Hospital, Ibadan, Nigeria.
East Afr Med J. 2001 May;78(5):272-4. doi: 10.4314/eamj.v78i5.9054.
Collagenous colitis is an established cause of chronic watery diarrhoea of unknown aetiopathogenesis, characterised by normal colonic endoscopic findings, and a prominent collagen band in the sub-epithelial layer on colonic mucosal histology. We report a case of a 65-year old male who presented with recurrent episodes of watery diarrhoea of 38 years duration. There was a positive family history of similar diarrhoea in the mother and two siblings. Colonoscopy done was macroscopically unremarkable except for a redundant sigmoid colon. Mucosal biopsy of the rectum and colon showed at histology atrophy of the mucosal lining, infiltration of the lamina propria by plasma cells and lymphocytes, and a thick band of collagenous tissue in the sub-epithelial zone of the lining mucosa. A high index of suspicion is necessary to make the diagnosis in patients with chronic diarrhoea, especially when common causes of chronic diarrhoea like intestinal parasitoses, HIV/AIDS, diabetic autonomic neuropathy, thyrotoxicosis have been excluded. It is suggested that colonoscopic examination with adequate biopsy should be performed in patients with chronic diarrhoea with no aetiologic agent identified.
胶原性结肠炎是慢性水样腹泻的既定病因，病因发病机制不明，其特征为结肠镜检查结果正常，而结肠黏膜组织学检查显示上皮下层有一条明显的胶原带。我们报告一例65岁男性，有持续38年的反复水样腹泻发作史。其母亲和两个兄弟姐妹有类似腹泻的家族史阳性。结肠镜检查除乙状结肠冗长外，大体上无异常。直肠和结肠黏膜活检组织学显示黏膜层萎缩、固有层有浆细胞和淋巴细胞浸润，以及衬里黏膜上皮下区有一条厚厚的胶原组织带。对于慢性腹泻患者，尤其是在排除了慢性腹泻的常见病因如肠道寄生虫病、艾滋病毒/艾滋病、糖尿病自主神经病变、甲状腺毒症后，必须高度怀疑才能做出诊断。建议对未查明病因的慢性腹泻患者进行结肠镜检查并进行充分活检。
