Meunier S, Villard F, Bouvier R, Lachaux A, Bertrand Y
Service d'hématologie pédiatrique, hôpital Debrousse, rue Soeur-Bouvier, 69322 Lyon cedex 05, France.
Arch Pediatr. 2001 Jan;8(1):47-50. doi: 10.1016/s0929-693x(00)00166-4.
When a child presents a severe anemia or resistant to iron supplementation, an upper gastrointestinal endoscopy has to be realized to find special causes.
We report observations of two patients, respectively 11 and 12 years old, who were admitted to hospital for a severe microcytic, hypochromic, aregenerative anemia (hemoglobin less than 50 g/L) due to an iron deficiency. The two children's history did not reveal a deficient diet, gastrointestinal tract disorder, ingested toxic or gastrotoxic drugs, or exteriorized hemorrhage. Upper gastrointestinal endoscopy showed a macroscopic pattern of gastritis. The stomach biopsies revealed subepithelial collagenous deposits.
The collagenous gastritis involves lesions similar to those described in the small intestine (collagenous sprue) and colon (collagenous colitis). The pathogenic factors of the three entities are presently unknown, but they are often associated with autoimmune pathology. These two observations are the third and the fourth pediatric cases described.
当儿童出现严重贫血或对铁剂补充治疗耐药时,必须进行上消化道内镜检查以寻找特殊病因。
我们报告了两名分别为11岁和12岁患者的观察情况,他们因缺铁性贫血入院,表现为严重的小细胞低色素性再生障碍性贫血(血红蛋白低于50g/L)。两名儿童的病史均未显示饮食不足、胃肠道疾病、摄入有毒或胃毒性药物或外部出血。上消化道内镜检查显示为胃炎的宏观表现。胃活检显示上皮下胶原沉积。
胶原性胃炎涉及与小肠(胶原性口炎性腹泻)和结肠(胶原性结肠炎)中描述的类似病变。这三种疾病的致病因素目前尚不清楚,但它们常与自身免疫性病理相关。这两例观察是所描述的第三和第四例儿科病例。