Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, Minnesota, USA.
Clin Gastroenterol Hepatol. 2010 Apr;8(4):344-349.e3. doi: 10.1016/j.cgh.2009.12.023. Epub 2010 Jan 6.
BACKGROUND & AIMS: Collagenous sprue (CS) is characterized by the presence of a distinctive band of subepithelial collagen deposition in the small bowel. We evaluated the clinical characteristics, treatments, and outcomes of patients with CS.
Thirty patients with CS were identified at the 3 Mayo Clinic sites between 1993 and 2009. Clinical data from medical records were reviewed.
The study cohort was 70% female (age range, 53-91 years). Most patients had severe diarrhea and weight loss. Hospitalization to treat dehydration was necessary in 16 (53%) patients. Associated immune-mediated diseases were noted in 70% of the patients; celiac disease was the most frequent. Other associated diseases were microscopic colitis, hypothyroidism, and autoimmune enteropathy. The median thickness of the layer of subepithelial collagen deposition in the small bowel was 29 mum (20-56.5 mum). Subepithelial collagen deposition in the colon or stomach was noted in 8 patients. A clinical response was observed in 24 (80%) patients after treatment with a combination of a gluten-free diet and immunosuppressive drugs. Histologic improvement was confirmed in 9 patients, with complete remission in 5. Two patients died (1 of complications of CS and 1 of another illness).
Most patients with CS are treated effectively with a combination of gluten-free diet and steroids. CS is often associated with collagen deposition or chronic inflammation in other segments of the gastrointestinal tract as well as other immune-mediated disorders.
胶原性肠病（CS）的特征是在小肠存在独特的上皮下胶原沉积带。我们评估了 CS 患者的临床特征、治疗方法和结局。
1993 年至 2009 年间，在 3 个梅奥诊所地点共发现 30 例 CS 患者。回顾了病历中的临床数据。
研究队列中 70%为女性（年龄 53-91 岁）。大多数患者有严重腹泻和体重减轻。16 例（53%）患者需要住院治疗脱水。70%的患者存在免疫介导的相关疾病；最常见的是乳糜泻。其他相关疾病为显微镜下结肠炎、甲状腺功能减退症和自身免疫性肠炎。小肠上皮下胶原沉积层的中位数厚度为 29 µm（20-56.5 µm）。8 例患者的结肠或胃有上皮下胶原沉积。24 例（80%）患者在接受无麸质饮食和免疫抑制剂联合治疗后观察到临床反应。9 例患者的组织学改善得到证实，其中 5 例完全缓解。2 例患者死亡（1 例 CS 并发症，1 例其他疾病）。
大多数 CS 患者经无麸质饮食和类固醇联合治疗可有效治疗。CS 常与胃肠道其他部位的胶原沉积或慢性炎症以及其他免疫介导的疾病有关。
