Case Report
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Oct 21, 2008; 14(39): 6083-6086
Published online Oct 21, 2008. doi: 10.3748/wjg.14.6083
A unique case of collagenous colitis presenting as protein-losing enteropathy successfully treated with prednisolone
Soichi Sano, Keiko Yamagami, Ayako Tanaka, Minako Nishio, Tomoyuki Nakamura, Yuki Kubo, Takeshi Inoue, Wataru Ueda, Kiyotaka Okawa, Katsunobu Yoshioka
Soichi Sano, Keiko Yamagami, Ayako Tanaka, Minako Nishio, Tomoyuki Nakamura, Katsunobu Yoshioka, Department of Internal Medicine, Osaka City General Hospital, Osaka 534-0021, Japan
Yuki Kubo, Takeshi Inoue, Department of Pathology, Osaka City General Hospital, Osaka 534-0021, Japan
Wataru Ueda, Kiyotaka Okawa, Department of Gastroen-terology, Osaka City General Hospital, Osaka 534-0021, Japan
Author contributions: Sano S, Yamagami K, Tanaka A, Nishio M, Nakamura T and Yoshioka K were involved in treatment of this patient; Ueda W and Okawa K contributed to the gastroenterological examination; Kubo Y and Inoue T contributed to the pathological examination; and Sano S, Yamagami K and Yoshioka K wrote the paper.
Correspondence to: Keiko Yamagami, MD, Department of Internal Medicine, Osaka City General Hospital, 2-13-22, Miyakojima-hon-dori, Miyakojima-ku, Osaka 534-0021, Japan. yamasanz@qb3.so-net.ne.jp
Telephone: +81-6-69291221 Fax: +81-6-69291091
Received: September 1, 2008
Revised: September 9, 2008
Accepted: September 16, 2008
Published online: October 21, 2008
Abstract

A 76-year-old woman with a 5-mo history of recurrent diarrhea and generalized edema was admitted to our hospital. Colonoscopy revealed edematous mucosa, and histopathological examination was compatible with collagenous colitis. Protein leakage from the colon, particularly in the ascending portion, was identified on 99mTc-human serum albumin scintigraphy. Collagenous colitis associated with protein-losing enteropathy (PLE) without small bowel disease was diagnosed. Prednisolone treatment ameliorated diarrhea and hypoproteinemia. Collagenous colitis should be included in the differential diagnosis of chronic diarrhea with hypoproteinemia for appropriate management.

Keywords: Collagenous colitis; Protein-losing enteropathy; Prednisolone; 99mTc-human serum albumin scintigraphy; chronic diarrhea