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COLLAGENOUS COLITIS IN AN ADULT PATIENT WITH CHRONIC DIARRHOEA: CASE REPORT
Abstract
Collagenous colitis is an established cause of chronic watery diarrhoea af unknown
adopathogenesis, characterised by normal colonic endoscopic findings, and a prominent
cdiagen band in the sub-epithelial layer on colonic mucosal histology. We report a case of a
65-year old male who presented with recurrent episodes of watery diarrhoea of 38 years
duration. There was a positive family history of similar diarrhoea in the mother and two
sibling. CoIonoscopy done was macroscopicsally unremarkable except for a redundant
sigrnoid colon. Mucosal biopsy of the rectum and colon showed at histology atrophy of the
mucosal lining, infiltration of' the lamina propria by plasma cells and lymphocytes, and a
thick band of collagenous tissue in the sub-epithelial zone of the lining mucosa. A high index
of suspicion is necessary to make the diagnosis in patients with chronic diarrhoea,especialIy
when common causes of chronic diarrhoea like intestinal parasitoses, HIVIAIDS, diabetic
autonomic neuropathy, thyrotoxicosis have been excluded. It is suggested that colmoscopic
examination with adcquate biopsy should bc performed in patients with chronic diarrhoea
with no aetiologic agent identified.
adopathogenesis, characterised by normal colonic endoscopic findings, and a prominent
cdiagen band in the sub-epithelial layer on colonic mucosal histology. We report a case of a
65-year old male who presented with recurrent episodes of watery diarrhoea of 38 years
duration. There was a positive family history of similar diarrhoea in the mother and two
sibling. CoIonoscopy done was macroscopicsally unremarkable except for a redundant
sigrnoid colon. Mucosal biopsy of the rectum and colon showed at histology atrophy of the
mucosal lining, infiltration of' the lamina propria by plasma cells and lymphocytes, and a
thick band of collagenous tissue in the sub-epithelial zone of the lining mucosa. A high index
of suspicion is necessary to make the diagnosis in patients with chronic diarrhoea,especialIy
when common causes of chronic diarrhoea like intestinal parasitoses, HIVIAIDS, diabetic
autonomic neuropathy, thyrotoxicosis have been excluded. It is suggested that colmoscopic
examination with adcquate biopsy should bc performed in patients with chronic diarrhoea
with no aetiologic agent identified.
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