COLLAGENOUS GASTRITIS REVEALED BY SEVERE ANEMIA IN A CHILD

collagenous gastritis is a rare histopathological disorder of unknown origin, characterized by a subepithelial collagen deposit greater than 10 mu m thick, associated with an inflammatory infiltrate of the gast ric mucosa. This report describes a second pediatric case of collageno us gastritis, revealed by severe anemia caused by gastric bleeding, as was the first case. Unlike the adult cases of collagenous gastritis, lesions were limited to the stomach, and remained unchanged on six ser ies of biopsies taken during a 30 month follow-up, despite treatment w ith omeprazole, sucralfate and corticosteroids. An immunohistochemical study showed signs of local immune activation on all biopsy specimens , including overexpression of HLA-DR by epithelial cells, increased nu mbers of CD3+ intraepithelial lymphocytes, and CD25+ cells in the lami na propria. Although the cause of the disease remains unclear, our fin dings suggest that the histopathological lesions of collagenous gastri tis may result from a local immune process. Copyright (C) 1998 by W.B. Saunders Company.