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Collagenous gastritis is a rare disease in the general population and collagenous colitis has seldom been reported in children. We report a girl with both diseases and review the literature on this association afetr a systematic search of Pubmed, Medline and Embase databases.. The girl, diagnosed of collagenous colitis at the age of 2 years, started with abdominal pain and anaemia at the age of 9 years and was diagnosed of collagenous gastritis in the gastric biopsies. After review of the literature, we found 66 reported cases (33 children, 33 adults, 68% females), 56 patients with collagenous gastritis and 16 children with collagenous colitis. Both disorders coexisted in 20 patients. The main presenting symptoms are abdominal pain and anaemia in patients with collagenous gastritis and diarrhoea and weight loss in patients with both disorders. Hypoalbuminemia was found in 9 patients with both diseases and protein losing enteropathy was demonstrated in 3 cases. Deposits of collagen in the duodenum were observed in 13 of 19 patients with both diseases. Seventeen of 66 patients had associated autoimmune disorders, particularly in patients with both diseases (35%). These conditions have a chronic course but gastric or colonic malignancies have not been communicated to date. In conclusion, collagenous gastritis and collagenous colitis mainly affects women and can occur at any age. Their association is exceptional. These disorders, although rare, should be considered in patients with anaemia and epigastric pain, watery diarrhoea or protein losing enteropathy.

Background: Eosinophilic esophagitis (EoE) is of growing interest for pediatricians and allergists. There is no general agreement about diagnostic and clinical management procedures. The objective of this prospective, observational study was to evaluate the efficacy of a protocol for the etiologic diagnosis and accurate treatment of EoE in the pediatric population., Patients and Methods: Starting in 2001, patients aged 0 to 14 years with a diagnosis of EoE were consecutively included in a protocol which included an allergy study. Depending on the results, an avoidance or elemental diet was established. Topical corticosteroids were prescribed to patients who rejected the diet. Clinical, endoscopic, and histological evaluation was performed to assess response. In the case of disease remission, challenge tests were performed to identify the offending food., Results: Seventeen patients were included. Most of them were male (14/17) and a high percentage (88%) had a history of allergy as well as a history of atopy in parents. Fifteen patients were sensitized to 1 or more foods. With this protocol and the subsequent treatment, 9 out of 17 patients were cured (1 out of 4 with swallowed corticosteroids, 3 out of 3 with an elemental diet, and 5 out of 12 with an avoidance diet). The offending food was identified in 8117 patients. Milk and eggs were the most common foods implicated., Conclusions: The allergy study was a useful diagnostic tool but it was not sufficient to identify the offending food.An elemental diet should be attempted before food is excluded as the cause of the disease.