Subject(s)
Colitis, Collagenous , Colitis , Humans , Colitis, Collagenous/diagnostic imaging , Colon , EndoscopySubject(s)
Colitis, Collagenous/diagnostic imaging , Colitis, Collagenous/pathology , Intestinal Mucosa/pathology , Aged , Chronic Disease , Colitis, Collagenous/chemically induced , Colon/diagnostic imaging , Colon/pathology , Diarrhea/drug therapy , Endoscopy, Digestive System/methods , Humans , Lansoprazole/adverse effects , Male , Proton Pump Inhibitors/adverse effectsSubject(s)
Colitis, Collagenous/complications , Moyamoya Disease/etiology , Stroke/complications , Colitis, Collagenous/diagnostic imaging , Computed Tomography Angiography , Female , Humans , Middle Aged , Moyamoya Disease/diagnostic imaging , Stroke/diagnostic imaging , Stroke/drug therapy , Tissue Plasminogen Activator/therapeutic use , Tomography Scanners, X-Ray ComputedABSTRACT
We herein describe a 69-year-old man suffering from chronic diarrhea caused by lansoprazole (LPZ)-induced collagenous colitis (CC) accompanied with protein-losing enteropathy (PLE), diagnosed by increased fecal alpha-1 antitrypsin clearance and the findings of leakage from the descending colon to the sigmoid colon on scintigraphy. MR enterocolonography (MREC) was also performed for differentiating digestive diseases, and inflamed findings were observed around the same portion as those on scintigraphy, suggesting that this region was responsible for protein loss in this case. The MREC findings improved after the cessation of LPZ, and hypoalbuminemia also improved simultaneously. This case suggests that MREC may be a new and useful diagnostic tool for CC with PLE.
Subject(s)
Colitis, Collagenous/chemically induced , Colitis, Collagenous/therapy , Diarrhea/chemically induced , Lansoprazole/adverse effects , Protein-Losing Enteropathies/diagnostic imaging , Protein-Losing Enteropathies/therapy , Aged , Colitis, Collagenous/diagnostic imaging , Diarrhea/therapy , Humans , Magnetic Resonance Imaging , Male , Protein-Losing Enteropathies/etiology , Rare Diseases/diagnosis , Rare Diseases/therapy , Treatment OutcomeABSTRACT
Collagenous colitis is a clinicopathologic syndrome characterized by chronic watery diarrhea and unique histopathologic features. Spontaneous colonic perforation in the setting of collagenous colitis is a highly unusual complication, with only three cases reported in the literature to date. We present a fourth case and propose a potential pathologic mechanism for acute colonic perforation in this patient population.
Subject(s)
Colitis, Collagenous/complications , Intestinal Perforation/etiology , Spontaneous Perforation/etiology , Colitis, Collagenous/diagnostic imaging , Colitis, Collagenous/pathology , Colonic Diseases/diagnostic imaging , Colonic Diseases/etiology , Colonic Diseases/pathology , Female , Humans , Intestinal Perforation/diagnostic imaging , Intestinal Perforation/pathology , Middle Aged , Spontaneous Perforation/diagnostic imaging , Spontaneous Perforation/pathology , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: Collagenous colitis (CC) is a chronic inflammatory bowel disease that affects the colon. However, some patients with CC present with accompanying pathologic small-bowel manifestations such as coeliac disease, defects in bile acid absorption and histopathologic changes in small-intestinal biopsies, indicating that CC is a pan-intestinal disease. In small-intestinal disease, the intestinal barrier function may be impaired, and the permeability of the small intestine altered. The purpose of this research was to study small-bowel function in patients with CC as expressed by intestinal permeability. MATERIAL AND METHODS: Ten patients with CC and chronic diarrhoea participated in the study. Coeliac disease was excluded by small-bowel biopsy and/or serology. Intestinal permeability was assessed as urinary excretion (ratios) 2, 4 and 6 h after ingestion of 14C-labelled mannitol (14C-mannitol) and 99mTc-labelled diethylenetriamine-pentaacetic acid (99mTc-DTPA). Data were compared with the results from healthy controls. RESULTS: No difference was found between groups in urinary excretion of 14C-mannitol and 99mTc-DTPA after 2, 4 or 6 h, respectively. Likewise, no significant differences in the 99mTc-DTPA/14C-mannitol ratios between patients and controls were detected after 2 h: 0.030 (0.008-0.130) versus 0.020 (0.007-0.030), p = 0.19, after 4 h: 0.040 (0.009-0.180) versus 0.020 (0.008-0.040), p = 0.14 or after 6 h: 0.040 (0.012-0.180) versus 0.020 (0.010-0.040), p = 0.17. CONCLUSIONS: No alterations in intestinal permeability in patients with CC could be demonstrated. Impairment of the integrity of the mucosa of the small bowel and the presence of a general dysfunction of the small intestine in patients with CC seem unlikely.
