[Celiac disease and collagenous colitis. A fortuitous association]

Area of Science:

• Gastroenterology
• Pathology

Background:

• Celiac disease involves small intestine inflammation and villous atrophy.
• Gluten-free diets are standard treatment for celiac disease.
• Collagenous colitis is a condition characterized by a collagen layer in the colon.

Observation:

• Two patients with celiac disease experienced chronic diarrhea despite strict gluten-free diets and normalized villous atrophy.
• Both patients were diagnosed with collagenous colitis.
• Six previous cases of this co-occurrence have been documented.

Findings:

• The co-occurrence of celiac disease and collagenous colitis is rare but reported.
• A previous hypothesis suggested gluten toxicity as a cause for collagen deposition in the colon.
• One patient showed increased collagen in the colon despite a gluten-free diet, contradicting the gluten toxicity hypothesis.

Implications:

• The findings suggest that collagenous colitis may occur independently of active gluten exposure in celiac disease patients.
• Further research is needed to understand the relationship between celiac disease and collagenous colitis.
• This challenges current understanding of the pathogenesis of collagenous colitis in celiac patients.