Thomas E. Starzl Transplantation Institute, Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania 15261, USA.
Inflamm Bowel Dis. 2012 Jul;18(7):1325-32. doi: 10.1002/ibd.21900. Epub 2012 Jan 31.
Collagenous colitis is a chronic inflammatory bowel disease of unknown etiology. It is fairly common in adult humans, but rare in infants, and has been associated with autoimmune disorders.
We report four infant baboons (age 7-12 months) that had received a transplant at 3 months of age and subsequent immunosuppressive therapy for periods of 4-10 months. All presented identical symptoms within a period of 4 weeks, including weight loss associated with chronic watery diarrhea that was unresponsive to standard antimicrobial treatment.
Clinical chemistry evaluations were within normal ranges, viral causes were ruled out, and fecal and blood cultures were repeatedly negative. At necropsy, two infant baboons were found to have a form of collagenous colitis. In the remaining two baboons that had identical clinical features, immunosuppressive therapy was discontinued and treatment with budesonide was initiated. Both baboons recovered and remained well on no medication until the end of follow-up (24 months).
Collagenous colitis has occasionally been reported in patients with organ transplants. It has been reported only once previously in baboons. The four cases reported here strongly suggest that 1) clinical features as well as histopathological findings of collagenous colitis in baboons are very similar to those in human patients; 2) it was associated with the immunocompromised state of the baboons, as two nonimmunosuppressed age-matched baboons in close proximity did not develop the condition; and 3) it may have had an infectious origin, as all four cases developed within a 4-week period of time.
胶原性结肠炎是一种病因不明的慢性炎症性肠病。它在成年人群中相当常见，但在婴儿中很少见，并与自身免疫性疾病有关。
我们报告了 4 只接受移植的幼猴（3 月龄），随后接受了 4-10 个月的免疫抑制治疗。所有幼猴在 4 周内出现了相同的症状，包括与慢性水样腹泻相关的体重减轻，而标准的抗菌治疗对此无效。
临床化学评估在正常范围内，排除了病毒原因，粪便和血液培养反复呈阴性。尸检时，发现两只幼猴患有胶原性结肠炎。在另外两只具有相同临床特征的幼猴中，停止了免疫抑制治疗，并开始使用布地奈德治疗。两只幼猴均恢复并在无药物治疗的情况下保持良好，直至随访结束（24 个月）。
胶原性结肠炎偶尔在器官移植患者中报告。在狨猴中仅报告过一次。这里报告的 4 个病例强烈提示：1）狨猴的胶原性结肠炎的临床特征和组织病理学发现与人类患者非常相似；2）它与狨猴的免疫抑制状态有关，因为在附近的 2 只未接受免疫抑制治疗的同龄狨猴未出现该疾病；3）它可能具有感染性起源，因为所有 4 例均在 4 周内发生。
