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Hi Everyone,

This is in response to many people who didn't know what collagenous sprue
was, but wanted to know if I found out anything would I send the info
back to the list. A librarian at Kennedy Memorial Hospital, Cherry Hill,
NJ found the following for me. (We know that if we do not keep to the
diet we can go into a refractory sprue.)

Refractory Sprue and Collagenous Sprue (Second Edition of Textbook of
Gastroenterology, J.B. Lippincott Company, Philadelphia 1995)
Patients who initially respond to a gluten-free diet many subsequently
relapse despite maintaining their diet. Such patients are then refractory
to further dietary therapy. In contrast, others are refractory to dietary
therapy from its inception and, assuming they are truly on a GF diet,
many not have celiac disease; these patients are said to have
unclassified sprue. Some refractory patients with celiac disease, typical
or atypical, respond to treatment with corticosteroids or other
immunosuppressive drugs. In others, there is no response and
malabsorption may be progressive.

Collagenous Sprue is characterized by the development of a thick band of
collagen-like material directly under the intestinal epithelial cells and
has been regarded by some as a separate entity from celiac disease.
However, subepithelial collagen deposition has been noted in up to 36% of
patients with classic celiac disease and in tropical sprue. Although
individuals with large amounts of subepithelial collagen may be
refractory to therapy, the presence of collagen does not , a riori,
preclude a successful response to a GF diet. Collagenous colitis
accompaning celiac disease also has been observed and whould be
considered in the diagnosis of diarrhea occurring in celiac disease
patients on a GF diet.

>From "The New England Journal of Medicine" Dec. 10, 1970 prints:
Collagenous sprue is a distinctive lesion of the intestinal mucosa
associated with progressive malabsorption. The intestinal pathology
is initially identified with the characteristic "flat" lesion of
untreated celiac sprue. Thereafter, bands of eosinophilic hyaline
material within the lamina propria become increasing apprarent. As
the disease progresses, the mucosa becomes progressively thinner.
Therapy, including the GF diet, does not help. Some cases currently
designated "refractory" or "unclassified" sprue many prove to be
collagenous sprue.

This info is a little detailed but definitely tells us to keep to the
diet.

Cindy in NJ