Collagenous gastritis: clinical features, histologic correlates and unanswered questions
Abstract
Collagenous gastritis (CG) is a rare gastrointestinal disorder characterized by subepithelial collagen deposition and lamina propria inflammation. Despite its first description over four decades ago, the pathogenesis remains unclear, with no standardized pathologic criteria/classification, treatment or established prognosis. A systematic PubMed search identified all English-language case reports, series and observational studies describing CG. Data on demographics, clinical presentation, endoscopic appearance and histologic features were extracted. Of the 133 patients with available demographic data, 101 patients had corresponding histologic information, reflecting the overall rarity and limited characterization of collagenous gastritis in the literature. The most common presenting symptoms were abdominal pain and chronic anaemia. A subset of patients had concurrent collagenous colitis, collagenous sprue, Helicobacter pylori gastritis or celiac disease. The predominant endoscopic finding was gastric mucosal nodularity, typically diffuse or corpus-predominant. Collagen band thickness ranged widely, with a median of 50.5 μm and a maximum of 225 μm. Band distribution was most commonly pan-gastric or corpus-predominant. Among the proposed histologic subtypes of CG, the atrophic pattern was most frequently observed and often correlated with isolated gastric involvement and lack of clinical or histologic remission. This review highlights that histologic classification may help…
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