Original article—alimentary tractGluten-Free Diet and Steroid Treatment Are Effective Therapy for Most Patients With Collagenous Sprue
Section snippets
Patients
All patients seen at Mayo Clinic sites in Rochester (n = 22), Jacksonville (n = 7), and Scottsdale (n = 5) from 1993–2009 with CS were identified. Medical records were reviewed, and only patients who met histologic and clinical criteria for CS were included.
Pathology Material Evaluation
Original pathology material was re-reviewed by a single pathologist (T.T.W.). Subepithelial collagen thickness was measured by using a micrometer-equipped Olympus DP71 digital camera (Olympus, Center Valley, PA). Two well-oriented fields
Patients
We included 30 patients (21 [70%] female) with a median age (range) at diagnosis of 72.5 years (53–91 years). Twenty-nine patients were white, and 1 was black. Symptoms had been present for a median (range) of 9 months (1–120 months) before the CS diagnosis. At presentation, all patients had diarrhea, and 97% experienced marked loss of weight (median loss, 27 pounds). Abrupt onset of diarrhea was noted in 8 patients. Transient acute renal failure caused by diarrhea occurred in 6 patients; none
Discussion
Collagenous sprue was first described in 1947 by Schein. 4 Since then, several more patients and small case series have been reported. 1, 5, 6, 8, 10, 27, 28, 29, 30, 31 Here we present the clinical characteristics, histologic findings, treatment, and prognosis of 30 patients with CS. This study represents the largest series of patients reported to date with the diagnosis of CS. Of clinical relevance, up to 80% of our patients had clinical response after treatment with a combination of
Acknowledgments
The authors thank Estela G. Staggs and Deanna Brogan for their assistance in collection of data and pathology material.
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Conflicts of interest The authors declare no conflicts.
Funding This article was supported by the National Institutes of Health (NIH), Ruth L. Kirschstein National Research Service Award/Training Grant in Gastrointestinal Allergy and Immunology (T32 AI-07047) (to A.R.T.), and NIH grant DK-57892 (to J.A.M.).