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Canadian Journal of Gastroenterology
Volume 13, Issue 4, Pages 347-350
Brief Communication

Hyposplenism, Antiendomysial Antibodies and Lymphocytic Colitis in Collagenous Sprue

Hugh J Freeman

Department of Medicine (Gastroenterology), University of British Columbia, Vancouver, British Columbia, Canada

Received 5 January 1999; Accepted 19 February 1999

Copyright © 1999 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


A 66-year-old woman was seen repeatedly over a decade to remove recurrent colonic adenomas and investigate episodes of watery diarrhea. Although the diarrhea was believed to be due to lymphocytic colitis, she developed weight loss, hypoproteinemia and hyposplenism that resulted in further studies, specifically to exclude celiac disease. Small intestinal biopsies, however, showed severely ‘flattened’ villous architecture with trichrome-positive subepithelial collagenous deposits, characteristic of collagenous sprue. Antiendomysial antibodies, known serological markers of celiac disease, were also detected. While collagenous sprue has been considered a distinct small intestinal disorder, the constellation of clinical and pathological findings in this patient suggests a close link with adult celiac disease.