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[Collagenous sprue]

P Hafkemeyer1, E Herbst, G Köhler

  • 1Abteilung Innere Medizin II, Universität, Freiburg.

Deutsche Medizinische Wochenschrift (1946)
|October 20, 1995
PubMed
Summary
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This case study shows that prednisolone effectively treats collagenous sprue, a rare small intestine disorder. The patient achieved remission with steroids and cyclosporine, suggesting an immune component in the disease.

Area of Science:

  • Gastroenterology
  • Immunology
  • Pathology

Background:

  • Collagenous sprue is a rare malabsorptive condition characterized by subepithelial collagen deposition in the small intestine.
  • This case involved a patient with type I diabetes mellitus presenting with severe diarrhea and malabsorption.

Observation:

  • Initial investigations suggested celiac disease, but a gluten-free diet was ineffective.
  • Duodenal and jejunal biopsies revealed villous atrophy and extensive collagen deposition, confirming collagenous sprue.

Findings:

  • Various treatments, including nutritional support and antibiotics, failed to control the severe fluid loss.
  • Prednisolone administration led to the disappearance of the collagen layer and partial villous regression.
  • Adjunctive cyclosporine therapy was required to manage a concurrent perimembranous glomerulonephritis and maintain remission.

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Implications:

  • This case highlights the efficacy of steroid therapy in managing collagenous sprue.
  • The co-occurrence of diabetes and immune-related conditions suggests a potential autoimmune etiology for collagenous sprue.