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Updated: Nov 18, 2025
Chronic Salmonella Infection Induced Intestinal Fibrosis
Published on: September 22, 2019
Novel Case Report: A Previously Reported, but Pathophysiologically Unexplained, Association Between Collagenous
Inayat Gill1, Aciel Ahmed Shaheen1, Ahmed Iqbal Edhi1
1Division of Gastroenterology, Department of Internal Medicine, William Beaumont Hospital at Royal Oak, 3535 W. Thirteen Mile Rd, Royal Oak, MI, 48073, USA.
Abstract:
Collagenous colitis (CC) is associated with non-bloody, watery diarrhea, which is pathophysiologically reasonable because normal colonic absorption (or excretion) of water and electrolytes can be blocked by the abnormally thick collagen layer in CC. However, CC has also been associated with six previous cases of protein-losing enteropathy (PLE), with no pathophysiologic explanation. The colon does not normally absorb (or excrete) amino acids/proteins, which is primarily the function of the small bowel. Collagenous duodenitis (CD) has not been associated with PLE. This work reports a novel case of CD (and CC) associated with PLE; a pathophysiologically reasonable mechanism for CD causing PLE (by the thick collagen layer of CD blocking normal intestinal amino acid absorption); and a novel association of PLE with severe COVID-19 infection (attributed to relative immunosuppression from hypoproteinemia, hypoalbuminemia, hypogammaglobulinemia, and malnutrition from PLE).
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