Case Report: Steroid-responsive recurrent iron-deficiency anemia in pediatric collagenous gastritis

Collagenous gastritis (CG) is a rare inflammatory disorder of the stomach and an uncommon but important cause of iron-deficiency anemia in children. Currently, there are no accepted therapeutic guidelines for treating these patients. We report a case in an 11-year-old boy who presented with recurrent iron-deficiency anemia requiring blood transfusion with an ultimate diagnosis of CG on repeat endoscopy. While iron supplementation and proton pump inhibitors failed to achieve clinical remission, the addition of oral prednisone effectively corrected the anemia. Notably, endoscopy improved despite persistent histologic damage. Our case demonstrates that CG should be considered in children with recurrent iron-deficiency anemia. It also underscores the potential role of corticosteroids in the treatment of refractory patients, which can achieve clinical remission even without histological improvement.