Agrawal Palack, Bhattar Keshav, Rojas Claudia, Larson Jacqueline
Pediatrics, Joe DiMaggio Children's Hospital, Hollywood, USA.
Internal Medicine, Memorial Healthcare, Hollywood, USA.
Cureus. 2024 Nov 3;16(11):e72939. doi: 10.7759/cureus.72939. eCollection 2024 Nov.
Collagenous gastroenteritidesare rare disorders of unknown etiology diagnosed histologically by marked subepithelial deposition of collagen bands thicker than 10µm in the lamina propria with a mononuclear inflammatory infiltrate. Collagenous gastritis (CG) is divided into two phenotypes - pediatric-onset and adult-onset. Up until recently, pediatric-onset CG was thought to be confined to the stomach presenting with abdominal pain and anemia with limited involvement of the colon. Whereas adult-onset CG is often associated with involvement of the small and/or large intestine presenting with chronic non-bloody diarrhea and weight loss. It is now acknowledged that adult-onset and pediatric-onset CG should be considered a similar disease on a continuous spectrum. There are limited case reports of pediatric patients diagnosed as CG with concurrent collagenous duodenitis (CD) and/or collagenous colitis (CC). There are no accepted therapeutic standards for treating these patients. We present a rare case of an adolescent male with selective IgA deficiency and growth hormone deficiency presenting with severe iron deficiency anemia and abdominal pain with an ultimate diagnosis of collagenous gastroduodenitis with suspected jejunal involvement.
胶原性胃肠病是病因不明的罕见疾病,通过组织学诊断,其特征为固有层中上皮下有厚度超过10µm的胶原带沉积,并伴有单核细胞炎性浸润。胶原性胃炎(CG)分为两种表型——儿童期发病型和成人期发病型。直到最近,儿童期发病型CG还被认为仅限于胃部,表现为腹痛和贫血,结肠受累有限。而成人期发病型CG常与小肠和/或大肠受累有关,表现为慢性非血性腹泻和体重减轻。现在人们认识到,成人期发病型和儿童期发病型CG应被视为同一连续谱系上的相似疾病。关于诊断为CG并发胶原性十二指肠炎(CD)和/或胶原性结肠炎(CC)的儿科患者的病例报告有限。目前尚无公认的治疗这些患者的标准。我们报告一例罕见病例,一名患有选择性IgA缺乏症和生长激素缺乏症的青少年男性,表现为严重缺铁性贫血和腹痛,最终诊断为胶原性胃十二指肠炎,疑似空肠受累。