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Pediatric Collagenous Gastritis: Clinical and Histologic Outcomes in a Large Pediatric Cohort
Beate C Beinvogl1, Jeffrey D Goldsmith2, Menno Verhave1
1Division of Pediatric Gastroenterology, Hepatology and Nutrition.
Insights
Pediatric collagenous gastritis (CG) often presents with abdominal pain and vomiting. Most children experience symptom resolution, and anemia effectively responds to iron supplementation, despite persistent collagen deposition.
Area of Science:
- Pediatric Gastroenterology
- Gastrointestinal Pathology
Background:
- Collagenous gastritis (CG) is a rare gastrointestinal disorder.
- Understanding its clinical presentation, treatment, and outcomes in children is crucial for effective management.
Purpose of the Study:
- To characterize the clinical features, treatment strategies, and outcomes of pediatric collagenous gastritis.
- To evaluate the long-term prognosis and response to interventions in affected children.
Main Methods:
- Retrospective cohort study involving 40 pediatric patients diagnosed with collagenous gastritis.
- Data collection included review of institutional pathology databases and medical records.
- Analysis of clinical data, endoscopic findings, and histological results.
Main Results:
- The study identified 40 pediatric patients with CG, with abdominal pain and vomiting being the most common symptoms.
- Endoscopic findings included gastric nodularity, visible blood, and erosions.
- While 87.5% of patients reported symptom improvement, persistent subepithelial collagen deposition was noted in 73.1%.
Conclusions:
- Pediatric collagenous gastritis, despite persistent histological findings, often leads to clinical symptom remission.
- Anemia associated with CG demonstrates a complete response to iron supplementation.
- Further research may explore targeted therapies for collagenous gastritis.
Objective:
The aim of the study was to present the clinical characteristics, treatment, and outcomes of pediatric collagenous gastritis (CG).
Method:
This is a retrospective cohort study. Patients were identified via query of the institutional pathology database. Clinical data was obtained by review of medical records.
Results:
Forty patients (57.5% female) were identified, mean age 11.3 ± 3.7 years (2-16years). Isolated CG was present in 66.7%, coexisting collagenous duodenitis (CD) in 17.5%, collagenous colitis (CC) in 7.5%, and collagenous ileitis in 2.5%. Atopic comorbidities were found in 25%, autoimmune comorbidities in 12.5%.
Presenting Symptoms:
Abdominal pain (77.5%), vomiting (65%), anemia (57.5%), nausea (55.5%), diarrhea (32.5%), anorexia (25.0%), weight loss (25%), gastrointestinal bleed (22.5%), poor growth (20%), poor weight gain (12.5%).
Endoscopic Findings:
All had abnormal endoscopic findings on esophago-gastro-duodenoscopy (EGD), most commonly gastric nodularity (77.5%), visible blood (20%), erosions/superficial ulcerations (10%), ulcers (7.5%). Histologically, all patients had increased subepithelial collagen deposition.
Treatment:
A variety of medications aimed towards inflammation and symptomatic treatment were used. Patients with anemia received iron supplementation and responded. Otherwise, there was no significant association of clinical or histologic improvement with specific treatments.
Clinical And Histologic Outcomes:
87.5% reported improvement or resolution of symptoms at the last follow-up (34.8 ± 27.0 months). Persistent sub-epithelial collagen was noted in 73.1% on the last EGD.
Conclusions:
Despite persistent findings of increased sub-epithelial collagen deposition during the follow-up period, most patients with CG show remission or resolution of clinical symptoms. Anemia responds to iron supplementation in all patients.
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