Patients with collagenous sprue were thought to have a dismal clinical course.
Some patients with collagenous sprue have coexisting collagenous colitis, lymphocytic gastritis, gastric metaplasia or heterotopia, or malignant lymphoma.
The evolution of therapeutic strategies is shedding light onto the progression and management of collagenous sprue. In the latest research on collagenous sprue outcomes, (8) where 19 cases were studied on multiple clinical, histopathologic, and molecular aspects, 8 patients (42%) responded to the gluten-free diet 10 patients (53%) responded to immunomodulatory therapy, only 1 patient (5%) died from complications of refractory sprue, and no patient developed lymphoma.
COLLAGENOUS SPRUE VERSUS CELIAC DISEASE: SEROLOGIC TESTS
For collagenous sprue, however, positive serology and/or specific HLA haplotype are not routinely associated with the diagnosis.
COLLAGENOUS SPRUE VERSUS CELIAC DISEASE VERSUS REFRACTORY SPRUE: HISTOPATHOLOGY AND IMMUNOPHENOTYPING
(7) In collagenous sprue (Figure 2, B through F), a variable degree of villous blunting is a consistent observation.
Interestingly, the histologic features of collagenous gastritis and collagenous sprue are similar to those seen in collagenous colitis.
Associated gastrointestinal diseases include celiac disease (20%), lymphocytic colitis, collagenous sprue, and lymphocytic gastritis.
Theories regarding the pathogenesis of collagenous gastritis and collagenous sprue suggest that the evolution of these diseases is similar to that of collagenous colitis, but there are few data to support or refute this.
Collagenous sprue differs from the others, with half of patients developing a progressive malabsorption that may lead to death.
Collagenous sprue: a clinicopathologic study of 12 cases.