Kuroiwa G, Takayama T, Sato Y, Takahashi Y, Fujita T, Nobuoka A, Kukitsu T, Kato J, Sakamaki S, Niitsu Y
Fourth Department of Internal Medicine, Sapporo Medical University, Japan.
J Gastroenterol. 2001 Feb;36(2):129-32. doi: 10.1007/s005350170142.
A 21-year-old man with diarrhea and edema was admitted to our hospital and diagnosed with protein-losing enteropathy caused by primary intestinal lymphangiectasia. He was placed, in turn, on a low-fat diet, an elemental diet, and, subsequently, fasting therapy with total parenteral nutrition (TPN) support. However, his symptoms were not relieved, but, rather were exacerbated. On the 45th day of hospitalization, octreotide therapy was initiated. After 2 weeks of treatment, his clinical symptoms, as well as hypoproteinemia and hypoalbuminemia, gradually became alleviated. The improvement was confirmed in terms of scintigraphy, endoscopy, and histology of the duodenum. The patient remained healthy until 6 months after the commencement of octreotide treatment, when he discontinued octreotide at his own discretion, at which point the symptoms recurred. Resumption of the drug, however, again brought about remission, which has continued until the present, March 2000. Thus, octreotide therapy is one modality which may be useful for refractory primary intestinal lymphangiectasia.
一名21岁腹泻伴水肿的男性患者入住我院，被诊断为原发性肠淋巴管扩张症所致的蛋白丢失性肠病。他依次接受了低脂饮食、要素饮食，随后是禁食疗法并给予全胃肠外营养（TPN）支持。然而，他的症状并未缓解，反而加重。住院第45天开始使用奥曲肽治疗。治疗2周后，他的临床症状以及低蛋白血症和低白蛋白血症逐渐缓解。十二指肠闪烁扫描、内镜检查和组织学检查均证实了病情的改善。该患者在奥曲肽治疗开始后6个月一直保持健康，之后他自行停用奥曲肽，此时症状复发。然而，重新使用该药物后再次实现缓解，这种缓解一直持续到2000年3月。因此，奥曲肽治疗是一种可能对难治性原发性肠淋巴管扩张症有用的治疗方式。
