Department of Pediatric Gastroenterology and Hepatology and Nutrition, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
Department of Anatomopathology, University hospital Leuven, KU Leuven, Leuven, Belgium.
Acta Gastroenterol Belg. 2023 Apr-Jun;86(2):363-366. doi: 10.51821/86.2.9374.
Collagenous duodenitis and gastritis are rare histopathological findings in children.
: We describe a four-year old girl, who presented with non-bloody diarrhea for two months and progressive edema with an albumin of 16g/dl.
The diagnosis of a protein losing enteropathy was made. Extensive investigations withheld only an infectious cause of the protein losing enteropathy (cytomegalovirus and adenovirus). However, the patients still required repetitive albumin infusions 3.5 months after onset of symptoms without spontaneous recovery. Therefore, a new endoscopic work-up was performed. Duodenal biopsies revealed collagen deposition, in association with a high number of eosinophils and mast cells throughout different parts of the gastrointestinal tract.
The collagen deposition seems to be triggered by an eosinophilic gastrointestinal disorder. Treatment was started with amino acid-based formula, oral iron therapy, an antihistamine, and a proton pomp inhibitor that resulted in persistent normalization of serum albumin already after 1.5 weeks.
胶原性十二指肠炎和胃炎是儿童中罕见的组织病理学发现。
我们描述了一位 4 岁女孩，她因两个月无血腹泻和白蛋白 16g/dl 的渐进性水肿而就诊。
诊断为蛋白丢失性肠病。广泛的调查仅排除了蛋白丢失性肠病的感染原因（巨细胞病毒和腺病毒）。然而，在症状出现 3.5 个月后，患者仍需要反复输注白蛋白，而没有自发恢复。因此，进行了新的内镜检查。十二指肠活检显示胶原沉积，与胃肠道不同部位的大量嗜酸性粒细胞和肥大细胞有关。
胶原沉积似乎是由嗜酸性粒细胞性胃肠病引起的。治疗开始时采用基于氨基酸的配方、口服铁剂、抗组胺药和质子泵抑制剂，在 1.5 周后血清白蛋白持续正常化。
