REPLY
Arthritis and Collagenous Colitis
J. Castanet, MD
1 August 1994 | Volume 121 Issue 3 | Page 237
IN RESPONSE:
The cause of collagenous colitis is unknown. Proposed pathogenic mechanisms include luminal toxicity, especially of gluten [1], an inflammatory process, and a primary defect in collagen turnover. As discussed by Kingham and colleagues [2] and Stampfl and coworkers [3] stimulation of collagen production by inflammation might be enhanced by coexistence of a defect in the regular control of collagen synthesis, such as scleroderma. We agree with Dr. Sowa that collagenous colitis and arthritis may be associated with gold toxicity. However, our patient had never received gold therapy at any time, and we believe that the association with lupus argues for an inflammatory origin. We must add that although none of the seven patients reported by Giardello and coworkers [4] had arthritis, the authors did discuss the relation between collagenous colitis and rheumatoid disease.
1. McCashland TM, Donovan JP, Stobach RS, Linder J, Quigley EM. Collagenous enterocolitis: a manifestation of gluten-sensitive enteropathy. J Clin Gastroenterol. 1992; 15:45-51.
2. Kingham JG, Levison DA, Morson BC, Dawson AM. Collagenous colitis. Gut. 1986; 27:570-7.
3. Stampfl DA, Friedman LS. Collagenous colitis. Pathophysiologic considerations. Dig Dis Sci. 1991; 36:705-11.
4. Giardiello FM, Bayless TM, Jessurun J, Hamilton SR, Yardley JH. Collagenous colitis: physiologic and histopathologic studies in seven patients. Ann Intern Med. 1987; 106:46-9.
About Letters
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
Top
References
Article
