Celiac.com 02/05/2010 - Collagenous sprue is classically understood as a disorder of the small intestinal mucosa marked by persistent diarrhea, severe malabsorption with multiple nutrient deficiencies, and progressive weight loss.
Patients with collagenous sprue typically show a severe to variably severe "flattened" mucosal biopsy lesion with distinctive sub-epithelial deposits in the lamina propria region. These deposits contain collagens, as demonstrated by both histochemical stains and ultrastructural studies.
Moreover, permanent disappearance of these deposits after resection of a localized colon cancer suggests that this disorder might actually involve a para-neoplastic morphologic marker of an occult malignancy.
In collagenous sprue cases, physicians often first consider a diagnosis of simple celiac disease, until the patient fails to respond to a gluten-free diet. Recent studies portray a close association between collagenous sprue and celiac disease, sometimes with concomitant T-cell enteropathy.
A number of studies demonstrate gastric and/or colonic associations with the unusual inflammatory mucosal process in collagenous sprue, which suggests that the condition may be more complex and have more varied contributing causes than presently understood.