Collagenous gastritis, hyperplastic polyp, and intraepithelial duodenal lymphocytosis in a 15-year-old child: An iconographic case report
Bibliographic record
Abstract
RATIONALE: Collagenous gastritis is an uncommon condition initially identified in 1989 by Colletti and Trainer, characterized by a subepithelial collagen band exceeding 10 μm in thickness. Two patient subgroups have been identified: children and young adults exhibiting severe anemia with illness confined to the gastric mucosa and no colonic involvement, and older individuals presenting with watery diarrhea and collagenous gastritis linked to collagenous colitis. A combination of hyperplastic polyps and Marsh I duodenal lymphocytosis has not been fully reported yet. PATIENT CONCERNS: A 15-year-old boy exhibited a prolonged history of fatigue, lethargy, weight reduction, and poor development. He exhibited iron deficiency anemia. Previous oral iron supplementation had been ineffective, necessitating the use of intravenous iron infusions. An endoscopy revealed a nodular, polypoid stomach with small polyps located in the antrum. DIAGNOSES: Biopsies revealed characteristics of collagenous gastritis, characterized by a thickened subepithelial band. A polyp exhibited elongated, architecturally distorted pits with outpouchings, cystic dilation, and papillary formation but without dysplasia. Intraepithelial lymphocytes exceeding 30 per 100 epithelial cells were seen in the small intestine. In our patient, pericryptal fibroblasts, inflammatory cells, and a distinctive subepithelial band made of randomly oriented collagen fibers were shown histologically and ultrastructurally. INTERVENTIONS: The patient was treated with lansoprazole 30 mg twice daily and famotidine 40 mg once daily, as well as oral iron supplementation. OUTCOMES: Clinical improvement was noted, and hemoglobin and ferritin levels were 123 g/L and 9 µg/L, respectively, at 12 months following therapy. LESSONS: In consideration of a colon-rectal cancer diagnosis of his father at the age of 45 years, we carried out a Search Tool for the Retrieval of Interacting Genes/Proteins and Pymol-based Protein Data Bank study and found that interleukin-4 may be the key factor supporting the occurrence of hyperplastic polyps in collagenous gastritis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".