Child with protein losing enteropathy as presentation of collagenous duodenitis and eosinophilic gastroenteritis

Acta Gastroenterol Belg. 2023 Apr-Jun;86(2):363-366. doi: 10.51821/86.2.9374.

Abstract

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.

Keywords: Collagen deposition; children; eosinophilic disorder.

Publication types

  • Case Reports

MeSH terms

  • Child, Preschool
  • Diarrhea* / etiology
  • Duodenitis* / diagnosis
  • Duodenitis* / drug therapy
  • Edema* / etiology
  • Female
  • Gastritis* / diagnosis
  • Gastritis* / drug therapy
  • Histamine Antagonists / administration & dosage
  • Humans
  • Protein-Losing Enteropathies* / diagnosis
  • Proton Pump Inhibitors / therapeutic use
  • Serum Albumin

Substances

  • Serum Albumin
  • Histamine Antagonists
  • Proton Pump Inhibitors

Supplementary concepts

  • Eosinophilic enteropathy