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Proximal collagenous gastroenteritides: Clinical management. A systematic review.
MedLine Citation:
PMID:  24716737     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aim. While collagenous colitis represents the most common form of the collagenous gastroenteritides, the collagenous entities affecting the proximal part of the gastrointestinal tract are much less recognized and possibly overlooked. The aim was to summarize the latest information through a systematic review of collagenous gastritis, collagenous sprue, and a combination thereof. Methods. The search yielded 117 studies which were suitable for inclusion in the systematic review. Excluding repeated cases, 89 case reports and 28 case series were reported, whereas no prospective studies with or without control groups were identified. Further, no randomized, controlled trials were identified. The total number of patients with proximal collagenous gastroenteritides reported was 330. Results. An overview of clinical presentations, prognosis, pathophysiology and histopathology, as well as management of these disorders is presented. The prognosis of both collagenous gastritis and sprue seems not to be as dismal as considered previously. Data point to involvement of immune or autoimmune mechanisms potentially driven by luminal antigens initiating the fibroinflammatory condition. Conclusions. To reach the diagnosis it is recommended that biopsies are obtained during gastroduodenoscopies. Therapies with anti-secretory strategies, glucocorticoids, and in some cases iron supplementation are suggested, although rational treatment options from randomized, controlled trials do not exist for these rare or even overlooked disorders.
Authors:
Ole Haagen Nielsen; Lene Buhl Riis; Silvio Danese; Rasmus Dahlin Bojesen; Christoffer Soendergaard
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-4-10
Journal Detail:
Title:  Annals of medicine     Volume:  -     ISSN:  1365-2060     ISO Abbreviation:  Ann. Med.     Publication Date:  2014 Apr 
Date Detail:
Created Date:  2014-4-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8906388     Medline TA:  Ann Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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