Collagenous Sprue

Clinical

Patients present with diarrhea, malabsorption and weight loss
- Has been included under the term Refractory Celiac Disease
Frequently associated with collagenous colitis (33%)
- Collagenous gastritis in 15%
Other associations
- Lymphocytic gastritis (10%)
- Ulcerative jejunitis (1 of 12 cases)
Age range 22 to 84 years
Variable response to steroids or gluten free diet
Variable reports of prognosis and response to therapy
- High mortality rate due to malnutrition in one series reporting very thick deposition(Maguire)
- 17/19 responsive to immunomodulatory therapy or gluten free diet with only 1/19 mortality in another series including only mild thickening(Vakiani)