Collagenous colitis in children and adolescents: Study of 7 cases and literature review

Xiuli Liu, Shu Yuan Xiao, Thomas P. Plesec, Wei Jiang, John R. Goldblum, Audrey J Lazenby

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

The aim of this study is to examine the clinical and pathologic characteristics of collagenous colitis (CC) in children and adolescents. Seven patients (five females and two males, median age: 13 years, ranging from 4 to 16) were included. Four (of 7, 57%) patients presented with non-bloody watery diarrhea, one with alternating constipation and diarrhea with rectal prolapse, one with constipation, and one with normal bowel movement. Abdominal pain and weight loss were manifested in 80 and 40% patients, respectively. Two patients had celiac disease in remission. None of the patients took non-steroidal antiinflammatory agents. All patients had normal colonoscopy, but had typical histologic features of CC in colon biopsies. Four patients had clinical follow-up (24-75 months duration, median 54 months): three patients had no gastrointestinal symptoms upon follow-up, but one patient had continued symptoms of alternating diarrhea and constipation. Two patients had follow-up biopsies: one showed persistence of CC, and one had complete histologic resolution. We conclude that while CC is rare in children and adolescents, the clinical presentation is similar to adults, with a female preponderance, presentation with diarrhea and abdominal pain, and an association with celiac disease and other autoimmune disorders. However, compared with adults, children and adolescents are more likely to have weight loss and an atypical presentation including alternating constipation and diarrhea, constipation alone or normal bowel movements. Treatment is less standardized in children and adolescents with CC.

Original languageEnglish (US)
Pages (from-to)881-887
Number of pages7
JournalModern Pathology
Volume26
Issue number6
DOIs
StatePublished - Jun 1 2013

Fingerprint

Collagenous Colitis
Constipation
Diarrhea
Celiac Disease
Abdominal Pain
Weight Loss
Rectal Prolapse
Biopsy
Non-Steroidal Anti-Inflammatory Agents
Colonoscopy
Colon

Keywords

  • Adolescent
  • budesonide
  • celiac disease
  • children
  • collagenous colitis
  • diarrhea
  • intraepithelial lymphocytosis
  • microscopic colitis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Collagenous colitis in children and adolescents : Study of 7 cases and literature review. / Liu, Xiuli; Xiao, Shu Yuan; Plesec, Thomas P.; Jiang, Wei; Goldblum, John R.; Lazenby, Audrey J.

In: Modern Pathology, Vol. 26, No. 6, 01.06.2013, p. 881-887.

Research output: Contribution to journalArticle

Liu, Xiuli ; Xiao, Shu Yuan ; Plesec, Thomas P. ; Jiang, Wei ; Goldblum, John R. ; Lazenby, Audrey J. / Collagenous colitis in children and adolescents : Study of 7 cases and literature review. In: Modern Pathology. 2013 ; Vol. 26, No. 6. pp. 881-887.
@article{4ad18deef6994796abdb2ef7735be193,
title = "Collagenous colitis in children and adolescents: Study of 7 cases and literature review",
abstract = "The aim of this study is to examine the clinical and pathologic characteristics of collagenous colitis (CC) in children and adolescents. Seven patients (five females and two males, median age: 13 years, ranging from 4 to 16) were included. Four (of 7, 57{\%}) patients presented with non-bloody watery diarrhea, one with alternating constipation and diarrhea with rectal prolapse, one with constipation, and one with normal bowel movement. Abdominal pain and weight loss were manifested in 80 and 40{\%} patients, respectively. Two patients had celiac disease in remission. None of the patients took non-steroidal antiinflammatory agents. All patients had normal colonoscopy, but had typical histologic features of CC in colon biopsies. Four patients had clinical follow-up (24-75 months duration, median 54 months): three patients had no gastrointestinal symptoms upon follow-up, but one patient had continued symptoms of alternating diarrhea and constipation. Two patients had follow-up biopsies: one showed persistence of CC, and one had complete histologic resolution. We conclude that while CC is rare in children and adolescents, the clinical presentation is similar to adults, with a female preponderance, presentation with diarrhea and abdominal pain, and an association with celiac disease and other autoimmune disorders. However, compared with adults, children and adolescents are more likely to have weight loss and an atypical presentation including alternating constipation and diarrhea, constipation alone or normal bowel movements. Treatment is less standardized in children and adolescents with CC.",
keywords = "Adolescent, budesonide, celiac disease, children, collagenous colitis, diarrhea, intraepithelial lymphocytosis, microscopic colitis",
author = "Xiuli Liu and Xiao, {Shu Yuan} and Plesec, {Thomas P.} and Wei Jiang and Goldblum, {John R.} and Lazenby, {Audrey J}",
year = "2013",
month = "6",
day = "1",
doi = "10.1038/modpathol.2012.227",
language = "English (US)",
volume = "26",
pages = "881--887",
journal = "Modern Pathology",
issn = "0893-3952",
publisher = "Nature Publishing Group",
number = "6",

}

TY - JOUR

T1 - Collagenous colitis in children and adolescents

T2 - Study of 7 cases and literature review

AU - Liu, Xiuli

AU - Xiao, Shu Yuan

AU - Plesec, Thomas P.

AU - Jiang, Wei

AU - Goldblum, John R.

AU - Lazenby, Audrey J

PY - 2013/6/1

Y1 - 2013/6/1

N2 - The aim of this study is to examine the clinical and pathologic characteristics of collagenous colitis (CC) in children and adolescents. Seven patients (five females and two males, median age: 13 years, ranging from 4 to 16) were included. Four (of 7, 57%) patients presented with non-bloody watery diarrhea, one with alternating constipation and diarrhea with rectal prolapse, one with constipation, and one with normal bowel movement. Abdominal pain and weight loss were manifested in 80 and 40% patients, respectively. Two patients had celiac disease in remission. None of the patients took non-steroidal antiinflammatory agents. All patients had normal colonoscopy, but had typical histologic features of CC in colon biopsies. Four patients had clinical follow-up (24-75 months duration, median 54 months): three patients had no gastrointestinal symptoms upon follow-up, but one patient had continued symptoms of alternating diarrhea and constipation. Two patients had follow-up biopsies: one showed persistence of CC, and one had complete histologic resolution. We conclude that while CC is rare in children and adolescents, the clinical presentation is similar to adults, with a female preponderance, presentation with diarrhea and abdominal pain, and an association with celiac disease and other autoimmune disorders. However, compared with adults, children and adolescents are more likely to have weight loss and an atypical presentation including alternating constipation and diarrhea, constipation alone or normal bowel movements. Treatment is less standardized in children and adolescents with CC.

AB - The aim of this study is to examine the clinical and pathologic characteristics of collagenous colitis (CC) in children and adolescents. Seven patients (five females and two males, median age: 13 years, ranging from 4 to 16) were included. Four (of 7, 57%) patients presented with non-bloody watery diarrhea, one with alternating constipation and diarrhea with rectal prolapse, one with constipation, and one with normal bowel movement. Abdominal pain and weight loss were manifested in 80 and 40% patients, respectively. Two patients had celiac disease in remission. None of the patients took non-steroidal antiinflammatory agents. All patients had normal colonoscopy, but had typical histologic features of CC in colon biopsies. Four patients had clinical follow-up (24-75 months duration, median 54 months): three patients had no gastrointestinal symptoms upon follow-up, but one patient had continued symptoms of alternating diarrhea and constipation. Two patients had follow-up biopsies: one showed persistence of CC, and one had complete histologic resolution. We conclude that while CC is rare in children and adolescents, the clinical presentation is similar to adults, with a female preponderance, presentation with diarrhea and abdominal pain, and an association with celiac disease and other autoimmune disorders. However, compared with adults, children and adolescents are more likely to have weight loss and an atypical presentation including alternating constipation and diarrhea, constipation alone or normal bowel movements. Treatment is less standardized in children and adolescents with CC.

KW - Adolescent

KW - budesonide

KW - celiac disease

KW - children

KW - collagenous colitis

KW - diarrhea

KW - intraepithelial lymphocytosis

KW - microscopic colitis

UR - http://www.scopus.com/inward/record.url?scp=84878601080&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878601080&partnerID=8YFLogxK

U2 - 10.1038/modpathol.2012.227

DO - 10.1038/modpathol.2012.227

M3 - Article

C2 - 23348901

AN - SCOPUS:84878601080

VL - 26

SP - 881

EP - 887

JO - Modern Pathology

JF - Modern Pathology

SN - 0893-3952

IS - 6

ER -