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Collagenous gastritis in children: A national cohort
Jonathan Illan Montero1, J Viala2, J Rebeuh3
1Department of Pediatrics, University Hospital of Vaud (CHUV), 1011 Lausanne, Switzerland.
Insights
Collagenous gastritis in children presents as abdominal pain and iron deficiency anemia. Long-term monitoring is crucial for managing this rare condition and understanding its progression.
Area of Science:
- Pediatric Gastroenterology
- Rare Diseases
- Histopathology
Background:
- Collagenous gastritis is a rare pediatric condition.
- It often presents with iron deficiency anemia and isolated gastric involvement.
- Current management and follow-up guidelines are lacking.
Purpose of the Study:
- To describe clinical data, endoscopic findings, and treatments for pediatric collagenous gastritis in France.
- To characterize the presentation and management of this rare disease in children.
Main Methods:
- Retrospective case collection from French pediatric centers.
- Inclusion criteria: collagenous gastritis diagnosis on gastric biopsies before 18 years of age.
- Data analysis included clinical presentation, endoscopic findings, and treatment outcomes.
Main Results:
- Twelve cases (4 males, 8 females) diagnosed between 1995-2022.
- Median age at diagnosis: 12.5 years.
- Common symptoms: abdominal pain and anemia (all patients).
- Histology showed basement membrane thickening (19-100 μm).
- Treatments included proton pump inhibitors (PPIs), iron supplementation, budesonide, and prednisone.
- Iron supplementation resolved anemia, but recurrence was common upon discontinuation.
Conclusions:
- Collagenous gastritis is an exceptional pediatric condition.
- Clinical manifestations include abdominal pain and iron deficiency anemia, likely due to bleeding.
- Long-term follow-up and disease monitoring are essential to understand progression risks.
Background:
Collagen gastritis is a rare disease that manifests in children mainly as isolated gastric involvement associated with martial deficiency anemia. There are no recommendations for the management and follow-up of these patients. We aimed to describe the clinical data, endoscopic findings, and treatments deployed in France's children with collagenous gastritis.
Methods:
All French pediatric gastroenterology centers and pediatric centers for rare digestive diseases (Centres de Maladies Rares Digestives) were contacted to collect cases of collagenous gastritis, defined on gastric biopsies and diagnosed before 18 years of age.
Results:
A total of 12 cases diagnosed (4 males and 8 females) between 1995 and 2022 could be analyzed. The median age at diagnosis was 12.5 years (7-15.2). The most frequent clinical presentation was abdominal pain (6/11) and/or nonspecific symptomatology attributed to anemia (8/10). Anemia was present in all children (11/11; Hb 2.8-9.1 g/dL). Nodular gastritis was present in 10 patients (antrum: 2; fundus: 4; in antrum and fundus: 4). All patients had a basement membrane thickening (from 19 to 100 μm). The treatments received were PPI (11), oral or intravenous martial supplementation (12), budesonide (1), and prednisone (1). Martial supplementation improved anemia in all cases. At discontinuation, nine of 10 patients had a recurrence of anemia.
Conclusion:
Collagenous gastritis is an exceptional condition, clinically manifested in children as abdominal pain and iron deficiency anemia probably of hemorrhagic origin. Patients require long-term follow-up and monitoring of their disease to describe the risk of progression better.
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