Clinical Case Study: Refractory Dyspepsia and Diffuse Gastric Atrophy in a Patient with Collagenous Gastritis
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By
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Yi-Ning Sun
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Li Tang
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Ying-Zhou Chen
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Jin-Lin Yang
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Zhu Wang
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July 16, 2026
Clinical Scorecard: Clinical Case Study: Refractory Dyspepsia and Diffuse Gastric Atrophy in a Patient with Collagenous Gastritis
At a Glance
| Category | Detail |
|---|
| Condition | Collagenous Gastritis |
| Key Mechanisms | Thickened subepithelial collagen deposition, mucosal inflammation, and epithelial injury. |
| Target Population | Adults with unexplained gastric atrophy and dyspeptic symptoms. |
| Care Setting | Gastroenterology clinic for evaluation of refractory dyspepsia. |
Key Highlights
- Collagenous gastritis can mimic autoimmune gastritis and present with gastric atrophy.
- Persistent hypogastrinemia and negative autoantibodies may indicate collagenous gastritis.
- Histopathological confirmation is essential for accurate diagnosis.
- Proton pump inhibitors may provide symptomatic relief in collagenous gastritis.
Guideline-Based Recommendations
Diagnosis
- Consider collagenous gastritis in patients with refractory dyspepsia and gastric atrophy.
- Use collagen-specific staining for histological confirmation.
Management
- Initiate proton pump inhibitor therapy for symptomatic relief.
Monitoring & Follow-up
- Regular follow-up for symptom improvement and laboratory evaluations.
Risks
- Misdiagnosis as autoimmune gastritis may delay appropriate treatment.
Patient & Prescribing Data
Adults with refractory dyspepsia and gastric atrophy.
Proton pump inhibitors can lead to marked symptomatic improvement.
Clinical Best Practices
- Perform comprehensive reassessment in patients with atypical gastric atrophy.
- Evaluate for collagenous gastritis when standard treatments fail.
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