Proximal collagenous gastroenteritides: Clinical management. A systematic review

Figures & data

Figure 1. Flow chart of the study screening process.

Table I. Subgroups of collagenous gastroenteritides showing common symptoms at presentation, gender and age distribution, usual treatment options, and prognosis.

Anatomic subgroups of collagenous gastroenteritides (excluding solely collagenous colitis)	Common presentations	Sex distribution; median (mean) age of onset	Usual treatment options	Prognosis from evaluation of available literature
Collagenous gastritis	• Anemia (iron) • Gastric pain • Belching/nausea • Vomiting • Fatigue	F/M: 1.6 17 (28) y (n = 50)	• PPI • Iron and folic acid supplementation • (Glucocorticoids)	Equivalent to background population
Collagenous gastritis and colitis	• Diarrhea • Anemia • Bloating • Vomiting • Weight loss	F/M: 4.5 18 (31) y (n = 11)	• PPI • Glucocorticoids • (Iron supplementation)	Equivalent to background population
Collagenous gastritis and sprue	• Diarrhea/watery stools • Bloating • Weight loss	F/M: 9.0 68 (62) y (n = 10)	• PPI • Glucocorticoids	Equivalent to background population
Collagenous gastritis, sprue, and colitis	• Bloating • Diarrhea • Weight loss • Nausea • Anemia	F/M: 1.1 57 (48) y (n = 17)	• Glucocorticoids	Equivalent to background population
Collagenous sprue	• Weight loss • Hypoalbuminemia • Diarrhea • Bloating • Anemia	F/M: 1.9 62 (59) y (n = 99)	• Glucocorticoids	Impaired prognoses with linkage to malignancy (especially T-cell lymphoma) and to complications following malnutrition
Collagenous sprue and colitis	• Nausea • Diarrhea • Abdominal pain • Weight loss	F/M: 2.6 62 (54) y (n = 29)	• Glucocorticoids	Equivalent to collagenous sprue

PPI = proton pump inhibitor; F = female; M = male.

Figure 2. Collagen deposition in duodenal biopsies. A: hematoxylin-eosin. B: Alcian blue/Picro–Sirius red. A diffuse collagen deposition beneath the basement membrane is found. Cellular elements and small capillaries are entrapped in the collagen layer.