由于神经元和 Cajal 间质细胞变性所致的严重特发性胃轻瘫：病理发现与处理
Severe idiopathic gastroparesis due to neuronal and interstitial cells of Cajal degeneration: pathological findings and management.
作者信息
Zárate N, Mearin F, Wang X-Y, Hewlett B, Huizinga J D, Malagelada J-R
机构信息
Digestive System Research Unit, University Hospital Vall d'Hebron, Autonomous University of Barcelona, 08035-Barcelona, Spain.
出版信息
Gut. 2003 Jul;52(7):966-70. doi: 10.1136/gut.52.7.966.
Abstract
Delayed gastric emptying can be due to muscular, neural, or humoral abnormalities. In the absence of an identified cause, gastroparesis is labelled as idiopathic. We present the case of a patient with severe idiopathic gastroparesis. Pharmacological approaches failed, as well as reduction in gastric emptying resistance with pyloric injection of botulinum toxin and pyloroplasty. Therefore, subtotal gastrectomy was performed. Histological and immunohistochemical study of the resected specimen showed hypoganglionosis, neuronal dysplasia, and a marked reduction in both myenteric and intramuscular interstitial cells of Cajal. To our knowledge, this is the first time these rare histological findings have been described in a patient with idiopathic gastroparesis.
摘要
胃排空延迟可能是由于肌肉、神经或体液异常所致。在未发现明确病因的情况下，胃轻瘫被标记为特发性。我们报告一例严重特发性胃轻瘫患者的病例。药物治疗方法无效，幽门注射肉毒杆菌毒素及幽门成形术以降低胃排空阻力的方法也无效。因此，实施了胃次全切除术。对切除标本进行的组织学和免疫组化研究显示神经节减少、神经元发育异常，以及肌间和肌内 Cajal 间质细胞显著减少。据我们所知，这是首次在特发性胃轻瘫患者中描述这些罕见的组织学发现。
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本文引用的文献
1
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Am J Gastroenterol. 2002 Jul;97(7):1653-60. doi: 10.1111/j.1572-0241.2002.05823.x.
2
Loss of interstitial cells of cajal and inhibitory innervation in insulin-dependent diabetes.胰岛素依赖型糖尿病中Cajal间质细胞的缺失及抑制性神经支配的丧失
Gastroenterology. 2001 Aug;121(2):427-34. doi: 10.1053/gast.2001.26264.
3
Development of interstitial cells of Cajal in a full-term infant without an enteric nervous system.一名无肠神经系统的足月婴儿中Cajal间质细胞的发育
Gastroenterology. 2001 Feb;120(2):561-7. doi: 10.1053/gast.2001.21200.
4
Remodeling of networks of interstitial cells of Cajal in a murine model of diabetic gastroparesis.糖尿病性胃轻瘫小鼠模型中Cajal间质细胞网络的重塑
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5
Interstitial cells of Cajal mediate cholinergic neurotransmission from enteric motor neurons.Cajal间质细胞介导来自肠运动神经元的胆碱能神经传递。
J Neurosci. 2000 Feb 15;20(4):1393-403. doi: 10.1523/JNEUROSCI.20-04-01393.2000.
6
Decreased interstitial cell of cajal volume in patients with slow-transit constipation.慢传输型便秘患者中 Cajal 间质细胞体积减小。
Gastroenterology. 2000 Jan;118(1):14-21. doi: 10.1016/s0016-5085(00)70409-4.
7
Loss of interstitial cells and a fibromuscular layer on the luminal side of the colonic circular muscle presenting as megacolon in an adult patient.成年患者结肠环形肌腔面的间质细胞和纤维肌层缺失，表现为巨结肠。
Gut. 1999 Nov;45(5):775-9. doi: 10.1136/gut.45.5.775.
8
Neural injury, repair, and adaptation in the GI tract. IV. Pathophysiology of GI motility related to interstitial cells of Cajal.胃肠道中的神经损伤、修复与适应。IV. 与 Cajal 间质细胞相关的胃肠动力病理生理学。
Am J Physiol. 1998 Sep;275(3):G381-6. doi: 10.1152/ajpgi.1998.275.3.G381.
9
Interstitial cells of Cajal generate a rhythmic pacemaker current.Cajal间质细胞产生节律性起搏电流。
Nat Med. 1998 Jul;4(7):848-51. doi: 10.1038/nm0798-848.
10
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Dig Dis Sci. 1998 Jan;43(1):80-9. doi: 10.1023/a:1018876021156.
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