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TL;DR
A 3-year-old girl with chronic diarrhea and lower extremity edema was diagnosed with collagenous gastroenteritis and colitis after endoscopy and biopsy demonstrated subepithelial collagen thickening in the stomach, duodenum, and colon.
ACG Case Reports Journal · 3 authors, 1 centre
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A 3-year-old girl with chronic diarrhea and lower extremity edema was diagnosed with collagenous gastroenteritis and colitis after endoscopy and biopsy demonstrated subepithelial collagen thickening in the stomach, duodenum, and colon.
A 3-year-old girl presented with 2 weeks of diarrhea progressing to fatigue, anuria, and nonpitting bilateral lower extremity edema. Laboratory evaluation revealed hypoalbuminemia, elevated triglycerides, low IgG, elevated IgA, elevated stool alpha-1-antitrypsin, and elevated calprotectin. Endoscopy with biopsies demonstrated thickening of the subepithelial collagen table in the stomach and duodenum with severe villous blunting, and collagenous colitis in the left colon, leading to a diagnosis of collagenous gastroenteritis and colitis. Treatment with budesonide was initiated for 8 weeks but the patient took it for only 1 week before refusal. Despite incomplete treatment, diarrhea lessened in severity and resolved within a few weeks, with normalization of albumin, triglycerides, and immunoglobulins.