46 Paediatric collagenous gastritis: A case series of a rare disease
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Résumé
Abstract Background Collagenous gastritis (CG) is a rare gastrointestinal disease whose pathogenesis and adequate treatments are yet to be established. CG is characterized by gastric subepithelial collagen deposition and chronic inflammation on histology. Paediatric CG is particularly understudied, with scarce literature available. We report nine paediatric cases from our tertiary care centre in Québec, Canada. Objectives To describe the clinical presentation, diagnostic challenges and treatment outcomes of paediatric CG. Design/Methods We conducted a retrospective review of paediatric patients diagnosed with CG at our tertiary care centre. Clinical, endoscopic and histopathological data were reviewed. Results Nine patients (ages 9-14 at first presentation) were included. On upper endoscopy, all 9 had nodular gastritis (all negative for Helicobacter pylori infections) with eosinophilic infiltration and subepithelial collagen band on histology compatible with CG. One patient had a type 1 diabetes, one had hypothyroidism and one had a previous episode of Henoch-Schönlein purpura. All patients had at least one or more gastrointestinal symptoms, namely abdominal pain, decreased appetite, weight loss, pyrosis, nausea or vomiting. One patient presented with two episodes of spontaneously-perforated gastric ulcers who underwent gastrorrhaphy with epiploonoplasty and two years later a partial gastrectomy. Four patients presented with severe-to-moderate iron-deficiency anemia (hemoglobin of 26-85 g/L), three of them requiring blood transfusions. Six patients achieved normal hemoglobin levels with oral iron supplements only. Seven patients were prescribed proton pump inhibitors (PPI), while three patients were additionally treated with oral budesonide. One patient remained asymptomatic on daily oral iron supplements. The patient who presented with the most severe iron-deficiency anemia (hemoglobin of 26 g/L), requiring multiple blood transfusions and oral iron supplementation, was treated with oral budesonide and PPI. This patient was found to have resolved CG on repeat endoscopy 3 years later. Conclusion Despite being described as an exceedingly rare disease in the literature, the number of cases reported in our center shows that the entity of CG is probably under-diagnosed. The most common presentation of CG in our paediatric population was iron-deficiency anemia with nodular gastritis seen on endoscopic evaluations. Regular monitoring and tailored treatment are crucial to manage CG in paediatric patients. Further research is needed to understand the pathogenesis and optimal management of this condition.
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Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
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Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle