Cadiot G, Flourie B, Galian A, Lavergne A, Modigliani R
Service de Gastroentérologie, Hôpital Saint-Lazare, Paris.
Presse Med. 1990 Oct 27;19(35):1621-2.
We report the cases of two patients with coeliac disease in whom chronic diarrhoea persisted in spite of strict adherence to a gluten free-diet and regression of intestinal villous atrophy. Collagenous colitis was evidenced in both patients. Six cases of such association have already been described. Because of subepithelial deposition of collagen in the colon of collagenous colitis and in the small intestine of coeliac disease, it has been suggested that the colonic collagen band might reflect a toxic effect of gluten on colonic epithelium. However, thickening of the colonic collagen band during strict gluten free-diet, as observed in one of our cases, is not in favour of this hypothesis.
我们报告了两例乳糜泻患者的病例,尽管他们严格坚持无麸质饮食且肠道绒毛萎缩有所消退,但慢性腹泻仍持续存在。两名患者均被证实患有胶原性结肠炎。此前已经描述过6例这种关联病例。由于胶原性结肠炎的结肠和乳糜泻的小肠中存在胶原的上皮下沉积,有人提出结肠胶原带可能反映了麸质对结肠上皮的毒性作用。然而,正如我们其中一例患者所观察到的,在严格的无麸质饮食期间结肠胶原带增厚,这并不支持这一假说。