Related Experiment Video
Updated: Jul 24, 2025
Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis
Published on: May 10, 2024
Child with protein losing enteropathy as presentation of collagenous duodenitis and eosinophilic gastroenteritis
K van Hoeve1, M De Keukelaere1, G De Hertogh2
1Department of Pediatric Gastroenterology and Hepatology and Nutrition, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
Insights
Collagenous gastritis and duodenitis in children, though rare, can cause protein-losing enteropathy. Prompt diagnosis and treatment with amino acid-based formula and medication led to rapid recovery.
Area of Science:
- Pediatric Gastroenterology
- Histopathology
- Gastrointestinal Disorders
Background:
- Collagenous duodenitis and gastritis are uncommon histopathological findings in pediatric patients.
- Protein-losing enteropathy presents a diagnostic challenge in children, often requiring extensive investigation.
Observation:
- A four-year-old girl presented with prolonged non-bloody diarrhea and severe hypoalbuminemia (16 g/dl), indicative of protein-losing enteropathy.
- Despite initial investigations ruling out common infectious causes (cytomegalovirus, adenovirus), the patient required repeated albumin infusions without improvement.
Findings:
- Endoscopic biopsies revealed significant collagen deposition in the duodenum, accompanied by elevated eosinophils and mast cells throughout the gastrointestinal tract.
- These findings suggest collagenous gastritis/duodenitis triggered by an eosinophilic gastrointestinal disorder.
Implications:
- Early diagnosis and targeted treatment, including specialized formulas and medications, can effectively manage collagenous gastritis/duodenitis and associated protein-losing enteropathy.
- This case highlights the importance of considering rare histopathological conditions in pediatric protein-losing enteropathy unresponsive to standard therapies.
Background:
Collagenous duodenitis and gastritis are rare histopathological findings in children.
Patients And Methods:
: We describe a four-year old girl, who presented with non-bloody diarrhea for two months and progressive edema with an albumin of 16g/dl.
Results:
The diagnosis of a protein losing enteropathy was made. Extensive investigations withheld only an infectious cause of the protein losing enteropathy (cytomegalovirus and adenovirus). However, the patients still required repetitive albumin infusions 3.5 months after onset of symptoms without spontaneous recovery. Therefore, a new endoscopic work-up was performed. Duodenal biopsies revealed collagen deposition, in association with a high number of eosinophils and mast cells throughout different parts of the gastrointestinal tract.
Conclusions:
The collagen deposition seems to be triggered by an eosinophilic gastrointestinal disorder. Treatment was started with amino acid-based formula, oral iron therapy, an antihistamine, and a proton pomp inhibitor that resulted in persistent normalization of serum albumin already after 1.5 weeks.
Related Concept Videos
01:21Overview of Protein Metabolism
Amino acids play various roles in the body once they are absorbed into cells. They are restructured...
01:20Inborn Errors of Metabolism
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:24Nephrotic Syndrome I : Introduction
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...