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Author Spotlight: Developing Innovative Therapeutic Strategies for Hemorrhagic Shock Research
Published on: March 22, 2024
Collagenous Gastritis: A Rare Cause of Hemorrhagic Shock
Brenton G Davis1, Max L Goldman1, Sarah C Cherny2
1Department of Gastroenterology, Kaiser Permanente Northern California, San Francisco, CA.
Insights
Collagenous gastritis (CG), a rare condition, can cause severe gastrointestinal bleeding. This case highlights a pediatric patient experiencing hemorrhagic shock from CG, necessitating advanced treatment.
Area of Science:
- Gastroenterology
- Pediatric Gastroenterology
- Rare Diseases
Background:
- Collagenous gastritis (CG) is a rare condition with distinct pediatric and adult phenotypes.
- Pediatric CG commonly presents with iron deficiency anemia and abdominal pain, unlike adult CG's typical diarrhea.
- Existing treatments for CG include oral iron, proton-pump inhibitors, and monitoring.
Observation:
- Massive gastrointestinal hemorrhage has not been previously described as a complication of CG.
- A pediatric patient with refractory CG presented with hemorrhagic shock.
- Diagnosis was confirmed via endoscopy following the acute gastrointestinal bleed.
Findings:
- This case represents the first documented instance of massive hemorrhage in collagenous gastritis.
- The patient required both initial and off-label step-up therapy to manage the condition.
- While 22.5% of pediatric CG involves some GI bleeding, massive hemorrhage is a novel presentation.
Implications:
- This case expands the known clinical spectrum of collagenous gastritis, particularly in pediatric patients.
- It underscores the need for considering CG in pediatric patients with severe GI bleeding and anemia.
- Further research into the pathophysiology and advanced treatment strategies for severe CG is warranted.
Abstract:
Collagenous gastritis (CG) is a rare condition comprised 2 phenotypes-pediatric and adult onset. While adult CG often presents with diarrhea, pediatric CG more often manifests with iron deficiency anemia and abdominal pain. Of the relatively few cases described since discovery, treatment has involved oral iron, proton-pump inhibitors, and close follow-up. While 22.5% of pediatric CG involves some form of gastrointestinal bleeding, massive hemorrhage resulting from CG has not previously been described. We present a case of refractory CG diagnosed on endoscopy after hemorrhagic shock due to an acute gastrointestinal bleed requiring both initial and off-label step-up therapy.
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