Pediatric Collagenous Gastroenterocolitis Successfully Treated with Methotrexate
A two-and-one-half-year-old previously healthy female presented with a ten-week history of watery diarrhea, nonbilious and nonbloody emesis, and low-grade fevers. She was found to have severe hypoalbuminemia and hypogammaglobulinemia. Her symptoms persisted, and she became dependent on parenteral nu...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2020/1929581 |
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| author | Beate C. Beinvogl Jeffrey D. Goldsmith Ramalingam Arumugam Michelle Kennedy Mani Mokalla Paul A. Rufo Menno Verhave |
| author_facet | Beate C. Beinvogl Jeffrey D. Goldsmith Ramalingam Arumugam Michelle Kennedy Mani Mokalla Paul A. Rufo Menno Verhave |
| author_sort | Beate C. Beinvogl |
| collection | DOAJ |
| description | A two-and-one-half-year-old previously healthy female presented with a ten-week history of watery diarrhea, nonbilious and nonbloody emesis, and low-grade fevers. She was found to have severe hypoalbuminemia and hypogammaglobulinemia. Her symptoms persisted, and she became dependent on parenteral nutrition. Biopsies obtained during subsequent endoscopic and colonoscopic studies revealed findings consistent with collagenous gastroenterocolitis. She responded to an empiric course of prednisone, but her symptoms recurred shortly after transitioning to oral budesonide. After successful reinduction with intravenous prednisone, intramuscular methotrexate was initiated. She remained asymptomatic during a 15-month course of therapy, and she continued to do well clinically until approximately nine months after weaning off methotrexate. At that point, she experienced a recurrence of diarrhea, and repeat endoscopic evaluation confirmed collagenous colitis. This responded nicely to a short course of oral budesonide, and she has since remained asymptomatic and off any therapy. |
| format | Article |
| id | doaj-art-e124f5ad690940b39757aa4ff787650e |
| institution | Kabale University |
| issn | 2090-6803 2090-6811 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pediatrics |
| spelling | doaj-art-e124f5ad690940b39757aa4ff787650e2025-08-20T03:25:59ZengWileyCase Reports in Pediatrics2090-68032090-68112020-01-01202010.1155/2020/19295811929581Pediatric Collagenous Gastroenterocolitis Successfully Treated with MethotrexateBeate C. Beinvogl0Jeffrey D. Goldsmith1Ramalingam Arumugam2Michelle Kennedy3Mani Mokalla4Paul A. Rufo5Menno Verhave6Division of Gastroenterology, Boston Children’s Hospital, Boston, MA, USADepartment of Pathology, Boston Children’s Hospital, Boston, MA, USAMinnesota Gastroenterology, PA, St. Paul, MN, USAMinnesota Gastroenterology, PA, St. Paul, MN, USAChildren’s Hospitals and Clinics of Minnesota, Minneapolis, MN, USADivision of Gastroenterology, Boston Children’s Hospital, Boston, MA, USADivision of Gastroenterology, Boston Children’s Hospital, Boston, MA, USAA two-and-one-half-year-old previously healthy female presented with a ten-week history of watery diarrhea, nonbilious and nonbloody emesis, and low-grade fevers. She was found to have severe hypoalbuminemia and hypogammaglobulinemia. Her symptoms persisted, and she became dependent on parenteral nutrition. Biopsies obtained during subsequent endoscopic and colonoscopic studies revealed findings consistent with collagenous gastroenterocolitis. She responded to an empiric course of prednisone, but her symptoms recurred shortly after transitioning to oral budesonide. After successful reinduction with intravenous prednisone, intramuscular methotrexate was initiated. She remained asymptomatic during a 15-month course of therapy, and she continued to do well clinically until approximately nine months after weaning off methotrexate. At that point, she experienced a recurrence of diarrhea, and repeat endoscopic evaluation confirmed collagenous colitis. This responded nicely to a short course of oral budesonide, and she has since remained asymptomatic and off any therapy.http://dx.doi.org/10.1155/2020/1929581 |
| spellingShingle | Beate C. Beinvogl Jeffrey D. Goldsmith Ramalingam Arumugam Michelle Kennedy Mani Mokalla Paul A. Rufo Menno Verhave Pediatric Collagenous Gastroenterocolitis Successfully Treated with Methotrexate Case Reports in Pediatrics |
| title | Pediatric Collagenous Gastroenterocolitis Successfully Treated with Methotrexate |
| title_full | Pediatric Collagenous Gastroenterocolitis Successfully Treated with Methotrexate |
| title_fullStr | Pediatric Collagenous Gastroenterocolitis Successfully Treated with Methotrexate |
| title_full_unstemmed | Pediatric Collagenous Gastroenterocolitis Successfully Treated with Methotrexate |
| title_short | Pediatric Collagenous Gastroenterocolitis Successfully Treated with Methotrexate |
| title_sort | pediatric collagenous gastroenterocolitis successfully treated with methotrexate |
| url | http://dx.doi.org/10.1155/2020/1929581 |
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