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Collagenous colitis and eosinophilic gastritis in a 4-year old girl: a case report and review of the literature


Anne M. Griffiths, MD, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada, M4S 1C5. Tel: +(416)813-7730 | Fax: +(416)813-6531 | Email:


Collagenous colitis (CC), a form of microscopic colitis, is characterized by a thick subepithelial collagen layer in the colon in the presence of chronic nonbloody watery diarrhoea and macroscopically normal-appearing colonic mucosa. Typically affecting elderly adults, CC is rare in children with only 12 cases previously reported in the literature. We report the case of a 4-year-old girl with CC associated with eosinophilic gastritis, which was clinically responsive to treatment with ketotifen, a benzocycloheptathiophene derivative, and H1 class of antihistamine that stabilizes mast cells and potentially impairs eosinophil migration to target organs. We review the published cases of paediatric-onset CC and summarize the links between eosinophils and CC in the clinical and basic science literature.

Conclusion: CC is a rare cause of chronic diarrhoea in children and may relate to mast cell and eosinophil activity.