Jeong Y S, Jun J B, Kim T H, Lee I H, Bae S C, Yoo D H, Park M H, Kim S Y
Division of Rheumatology, Hospital for Rheumatic Diseases, Seoul, Korea.
Clin Exp Rheumatol. 2000 Sep-Oct;18(5):619-21.
Secondary amyloidosis is an occasional complication of ankylosing spondylitis (AS) and in most cases renal amyloidosis presents with proteinuria, nephrotic syndrome and decreased renal function. We describe a 32-year-old male patient with AS manifested by frequent diarrhea, intermittent abdominal pain and low serum albumin levels. He has suffered from severe inflammatory back pain for 14 years with multiple peripheral joint involvement. Protein-losing enteropathy due to gastrointestinal amyloidosis was diagnosed with 99mTc-human albumin scintigraphy, fecal alpha-1 antitrypsin clearance and colonoscopic biopsy with Congo red staining. Somatostatin analogue octreotide and prednisolone were introduced with successful result.
继发性淀粉样变性是强直性脊柱炎（AS）的一种偶发并发症，在大多数情况下，肾淀粉样变性表现为蛋白尿、肾病综合征和肾功能减退。我们描述了一名32岁男性AS患者，其表现为频繁腹泻、间歇性腹痛和低血清白蛋白水平。他患有严重的炎性背痛14年，伴有多个外周关节受累。通过99mTc-人白蛋白闪烁显像、粪便α-1抗胰蛋白酶清除率测定以及刚果红染色的结肠镜活检，诊断为胃肠道淀粉样变性所致的蛋白丢失性肠病。使用生长抑素类似物奥曲肽和泼尼松龙治疗取得了成功。
