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• W2333074580 abstract "A 5-year-old white boy presented with a history of chronic diarrhea, occasional abdominal pain, fecal urgency, and poor weight gain. His medical history was significant for asthma requiring intermittent administration of corticosteroids and albuterol. Family history was negative for autoimmune diseases including celiac and inflammatory bowel disease. Laboratory investigations including stool studies, hemogram, thyroid function tests, celiac serology, esophagogastroduodenoscopy, and colonoscopy (Fig. 1A) were normal. Histological examination of colonic biopsies (Fig. 1B, C, and D) revealed classic features of collagenous colitis (CC), a rare cause of diarrhea in children (1). Considered to be a variant of microscopic colitis, CC is mostly seen in women between 50 and 70 years old presenting with diarrhea (95%), weight loss (41%), abdominal pain (40%), fecal urgency (29%), and nocturnal stools (22%) (2–4). Management of CC is largely empiric, frequently requiring combination of agents from 5-aminosalicylate compounds, glucocorticoids, bile acid resins, bulking agents, and antidiarrheals (5). Since the initial diagnosis 2 years ago, none of these agents have induced a sustained remission of our patient's symptoms, although temporary relief was reported following the use of systemic corticosteroids. The long-term outlook for pediatric CC is not known. In adults, it typically follows a remitting and relapsing course over the span of many years, and the assessment of response to a given therapy may also be a real challenge.FIGURE 1: Collagenous colitis. A, Normal endoscopic examination of the colon. B, Hematoxylin and eosin staining of colonic biopsies showing subepithelial collagen deposition (black arrows), further illustrated by trichrome staining (C, black arrows). Shown in (D) is 400× magnification of the box in (B) depicting the table of sub-epithelial collagen (black arrows); increased numbers of intraepithelial lymphocytes (clear arrows); and superficial plasmacytosis with prominent eosinophils (red arrows). Healthy-appearing crypts recognized in (B) and (D) are also a typical feature of collagenous colitis." @default.
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• W2333074580 date "2011-05-01" @default.
• W2333074580 modified "2023-10-16" @default.
• W2333074580 title "Classic Disease Presenting at the Wrong Age: Rare Cause of Chronic Diarrhea in Children" @default.
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• W2333074580 doi "https://doi.org/10.1097/mpg.0b013e3182065fda" @default.
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