Collagenous sprue diagnosed by double balloon endoscopy.

Area of Science:

• Gastroenterology
• Internal Medicine
• Diagnostic Endoscopy

Background:

• Chronic diarrhea and malabsorption syndromes require accurate diagnosis.
• Double balloon endoscopy (DBE) offers advanced visualization of the small intestine.

Observation:

• A 58-year-old Japanese man presented with chronic diarrhea, initially suspected as malabsorption syndrome.
• DBE revealed characteristic mucosal changes: reduced folds, scalloping, nodularity, and granularity.

Findings:

• Jejunal biopsies demonstrated severe villous atrophy and subepithelial collagen bands.
• These pathological findings confirmed the diagnosis of collagenous sprue (CS).

Implications:

• This is the first reported case of collagenous sprue in Japan.
• DBE is a valuable tool for diagnosing CS and other causes of unexplained diarrhea.
• Management involved total parenteral nutrition and a gluten-free diet, leading to symptom improvement.