Clinical and histological resolution of collagenous sprue following gluten-free diet and discontinuation of non-steroidal anti-inflammatory drugs (NSAIDs).

Abstract

Collagenous sprue is a rare small bowel enteropathy that has overlapping clinical features with coeliac disease; it is commonly associated with arthritic autoimmune conditions, which often require non-steroidal anti-inflammatory drugs (NSAIDs). In the limited published literature available, there are putative suggestions of a link between NSAID use and collagen deposition in intestinal subepithelia in such patients. The authors present a case of a 43-year-old woman with long-standing NSAID use for autoimmune polyarthropathy and positive coeliac antibodies. However, distal duodenal biopsies revealed a thickened band of subepithelial collagen with villous atrophic appearances consistent with collagenous sprue. The patient was treated with a gluten-free diet and her NSAIDs were discontinued. After 6 months, her gastrointestinal symptoms had resolved with complete histological resolution of the collagenous subepithelial bands and villous atrophy on duodenal biopsy.

• Authors: D H Vasant, S Hayes, R Bucknall, S Lal
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2013 (Aug 28 2013) ISSN: 1757-790X [Electronic] England
• PMID: 23986126 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal

Topics

• Adult
• Anti-Inflammatory Agents, Non-Steroidal (adverse effects)
• Collagenous Sprue (diet therapy, pathology)
• Diet, Gluten-Free
• Duodenum (pathology)
• Female
• Humans
• Treatment Outcome