Chen CN, Fan XY, Yang CM, Zhang XH, Liu J. Refractory chronic diarrhea complicated with optic neuritis in a young woman: A case report. World J Gastrointest Endosc 2025; 17(7): 106208 [DOI: 10.4253/wjge.v17.i7.106208]
Corresponding Author of This Article
Jin Liu, Doctor, Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan 250000, Shandong Province, China. miracle713@163.com
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Jul 16, 2025; 17(7): 106208 Published online Jul 16, 2025. doi: 10.4253/wjge.v17.i7.106208
Refractory chronic diarrhea complicated with optic neuritis in a young woman: A case report
Chao-Nan Chen, Xin-Yu Fan, Chong-Mei Yang, Xiao-Hua Zhang, Jin Liu
Chao-Nan Chen, Xin-Yu Fan, Chong-Mei Yang, Xiao-Hua Zhang, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, Shandong Province, China
Jin Liu, Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, Shandong Province, China
Co-corresponding authors: Xiao-Hua Zhang and Jin Liu.
Author contributions: Chen CN wrote the manuscript; Fan XY provided technical and material support; Yang CM provided guidance and consultation; Zhang XH and Liu J as co-corresponding authors revised the manuscript. All the authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin Liu, Doctor, Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324 Jingwu Road, Jinan 250000, Shandong Province, China. miracle713@163.com
Received: February 19, 2025 Revised: April 6, 2025 Accepted: May 20, 2025 Published online: July 16, 2025 Processing time: 140 Days and 4 Hours
Abstract
BACKGROUND
Collagenous sprue is a serious intestinal malabsorption disorder characterized by dull and flattened intestinal villi with subepithelial collagen deposition. At present, fewer than 100 cases have been reported in the literature. Owing to the rarity of this disease, clinicians and pathologists have insufficient understanding of it.
CASE SUMMARY
The authors present a case of a 34-year-old female patient who presented with severe watery diarrhea with significant weight loss. She also experienced blurred binocular vision. The intestinal lesions were located mainly in the small intestine, which presented flat and dull intestinal villi with subepithelial collagen deposition. Masson staining was positive. Glucocorticoids were effective for this patient, but there seemed to be glucocorticoid dependence.
CONCLUSION
Collagenous stomatitis diarrhea is a rare intestinal malabsorption disease that needs to be diagnosed in combination with special clinical manifestations and unique histological features.
Core Tip: Collagenous sprue is a rare and unrecognized cause of diarrhea and weight loss and affects mainly the duodenum and small bowel. The clinical picture often resembles that of celiac sprue, the main differential diagnosis, albeit refractory to a gluten-free diet. The histological features are fundamentally characterized by the deposition of collagen beneath the basement membrane of the gut mucosa. Treatment should be initiated as soon as the diagnosis is established to prevent the progression of fibrosis. We describe the case of a 34-year-old woman with a collagenous sprue, her diagnostic workup, histopathological examination, and response to treatment. This case can inform future clinicians to aid in timely and correct diagnosis.
