Digestive Diseases and Sciences

, Volume 43, Issue 6, pp 1341–1346 | Cite as

Collagenous Colitis and Yersinia enterocolitica Infection

  • M. Makinen
  • S. Niemela
  • J. Lehtola
  • T. J. Karttunen


Collagenous colitis is a rare clinical andpathological entity characterized by watery diarrhea anddeposition of collagen beneath the surface epithelium ofthe colon. Its etiology is unknown. We present a careful retrospective clinicopathologicalanalysis of six patients with collagenous colitisdiagnosed at our hospital during a three-year period.Three of the patients had had a Yersinia enterocolitica infection, detected by stool culture andelevated serum antibody titers, preceding the diagnosisof collagenous colitis. Four patients had duodenalvillous atrophy, which in two patients was refractory to a gluten-free diet. We propose that Yersiniaenterocolitica infection may be a triggering factor forthe development of collagenous colitis in some cases.Duodenal villous atrophy not responding to gluten withdrawal is common in association withcollagenous colitis.



Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Lindstrom CG: “Collagenous colitis” with watery diarrhea-a new entity? Pathol Eur 11:87-89, 1976Google Scholar
  2. 2.
    Tanaka M, Mazzoleni G, Riddell RH: Distribution of collagenous colitis: Utility of flexible sigmoidoscopy. Gut 33:65-70, 1992Google Scholar
  3. 3.
    Lazenby AJ, Yardley JH, Giardiello FM, Bayless TM: Pitfalls in the diagnosis of collagenous colitis: Experience with 75 cases from a registry of collagenous colitis at the Johns Hopkins Hospital. Hum Pathol 21:905-910, 1990Google Scholar
  4. 4.
    Carpenter HA, Tremaine WJ, Batts KP, Czaja AJ: Sequential histologic evaluations in collagenous colitis: Correlations with disease behavior and sampling strategy. Dig Dis Sci 37:1903- 1909, 1992Google Scholar
  5. 5.
    Giardiello FM, Bayless TM, Jessurun J, Hamilton SR, Yardley JH: Collagenous colitis: physiologic and histopathologic studies in seven patients. Ann Intern Med 106:46–49, 1987Google Scholar
  6. 6.
    Widgren S, Jlidi R, Cox JN: Collagenous colitis: histologic, morphometric, immunohistochemical and ultrastructural studies. Report of 21 cases. Virchows Arch A Pathol Anat Histopathol 413:287-296, 1988Google Scholar
  7. 7.
    Stampfl DA, Friedman LS: Collagenous colitis: Pathophysiologic considerations. Dig Dis Sci 36:705-711, 1991Google Scholar
  8. 8.
    Andersen T, Andersen JR, Tvede M, Franzmann MB: Collagenous colitis: Are bacterial cytotoxins responsible? Am J Gastroenterol 88:375-377, 1993Google Scholar
  9. 9.
    Riddell RH, Tanaka M, Mazzoleni G: Non-steroidal anti-in flammatory drugs as a possible cause of collagenous colitis: A case-control study. Gut 33:683-686, 1992Google Scholar
  10. 10.
    Giardiello FM, Hansen FC 3rd, Lazenby AJ, Hellman DB, Milligan FD, Bayless TM, Yardley JH: Collagenous colitis in setting of nonsteroidal anti-inflammatory drugs and antibiotics. Dig Dis Sci 35:257-260, 1990Google Scholar
  11. 11.
    Dixon MF, Genta RM, Yardley JH, Correa P: Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 20:1161-1181, 1996Google Scholar
  12. 12.
    Rams H, Rogers AI, Ghandur-Mnaymneh L: Collagenous colitis. Ann Intern Med 106:108-113, 1987Google Scholar
  13. 13.
    Wang KK, Perrault J, Carpenter HA, Schroeder KW, Tre-maine WJ: Collagenous colitis: A clinicopathologic correlation. Mayo Clin Proc 62:665-671, 1987Google Scholar
  14. 14.
    Jessurun J, Yardley JH, Giardiello FM, Hamilton SR, Bayless TM: Chronic colitis with thickening of the subepithelial collagen layer (collagenous colitis): Histopathologic findings in 15 patients. Hum Pathol 18:839-848, 1987Google Scholar
  15. 15.
    Fausa O, Foerster A, Hovig T: Collagenous colitis. a clinical, histological, and ultrastructural study. Scand J Gastroenterol Suppl 107:8-23, 1985Google Scholar
  16. 16.
    Kingham JG, Levison DA, Morson BC, Dawson AM: Collagenous colitis. Gut 27:570-577, 1986Google Scholar
  17. 17.
    Hoogkamp-Korstanje JA, de Koning J, Heesemann J: Persistence of Yersinia enterocoliticain man. Infection 16:81-85, 1988Google Scholar
  18. 18.
    Granfors K, Lahesmaa-Rantala K, Toivanen A: IgM, IgG, and IgA antibodies in Yersiniainfection. J Infect Dis 157:601- 602, 1988 (letter).Google Scholar
  19. 19.
    Ahvonen P: Human yersiniosis in Finland. II. Clinical features. Ann Clin Res 4:39-48, 1972Google Scholar
  20. 20.
    Ahvonen P: Human yersiniosis in Finland. I. Bacteriology and serology. Ann Clin Res 4:30-38, 1972Google Scholar
  21. 21.
    Cover TL, Aber RC: Yersinia enterocolitica.N Engl J Med 321:16-24, 1989Google Scholar
  22. 22.
    Bohr J, Tysk C, Eriksson S, Jarnerot G: Collagenous colitis in Orebro, Sweden, an epidemiological study 1984-1993. Gut 37:394-397, 1995Google Scholar
  23. 23.
    Saebo A, Lassen J: Acute and chronic gastrointestinal manifestations associated with Yersinia enterocoliticainfection. A Norwegian 10-year follow-up study on 458 hospitalized patients. Ann Surg 215:250-255, 1992Google Scholar
  24. 24.
    Baines M, Ebringer A: HLA and disease. Mol Aspects Med 13:263-378, 1992Google Scholar
  25. 25.
    Hughes R, Keat A: Reactive arthritis: The role of bacterial antigens in inflammatory arthritis. Baillieres Clin Rheumatol 6:285-308, 1992Google Scholar
  26. 26.
    Perisic VN, Kokai G: Diarrhea caused by collagenous colitis. Arch Dis Childhood 64:867-869, 1989Google Scholar
  27. 27.
    Hamilton I, Sanders S, Hopwood D, Bouchier IA: Collagenous colitis associated with small intestinal villous atrophy. Gut 27:1394-1398, 1986Google Scholar
  28. 28.
    O'Mahony S, Nawroz IM, Ferguson A: Coeliac disease and collagenous colitis. Postgrad Med J 66:238-241, 1990Google Scholar
  29. 29.
    Armes J, Gee DC, Macrae FA, Schroeder W, Bhathal PS: Collagenous colitis: Jejunal and colorectal pathology. J Clin Pathol 45:784-787, 1992Google Scholar
  30. 30.
    McCashland TM, Donovan JP, Strobach RS, Linder J, Quigley EM: Collagenous enterocolitis: a manifestation of glutensensitive enteropathy. J Clin Gastroenterol 15:45-51, 1992Google Scholar
  31. 31.
    Bogomoletz WV, Flejou JF: Newly recognized forms of colitis: Collagenous colitis, microscopic (lymphocytic) colitis, and lymphoid follicular proctitis. Semin Diagn Pathol 8:178-189, 1991Google Scholar

Copyright information

© Plenum Publishing Corporation 1998

Authors and Affiliations

  • M. Makinen
  • S. Niemela
  • J. Lehtola
  • T. J. Karttunen

There are no affiliations available

Personalised recommendations