Complete Histological Resolution of Collagenous Sprue

Complete Histological Resolution of Collagenous Sprue

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A 65-year-old woman developed a watery diarrhea syndrome with Pictures collagenous colitis.Later, weight loss and hypoalbuminemia were documented.This prompted small bowel biopsies that showed pathological changes of collagenous sprue.An apparent treatment response to a gluten-free diet and prednisone resulted in reduced diarrhea, weight gain and normalization of serum albumin.Later repeated biopsies from multiple small and large bowel sites over a period of over three years, however, showed reversion to normal cutting board small intestinal mucosa but persistent collagenous colitis.

These results indicate that collagenous inflammatory disease may be a far more extensive process in the gastrointestinal tract than is currently appreciated.Moreover, collagenous colitis may be a clinical signal that occult small intestinal disease is present.Finally, collagenous sprue may, in some instances, be a completely reversible small intestinal disorder.