Matsumoto Masataka, Nakamura Takefumi, Ohashi Tsuyoshi, Okuno Tomoko, Takasu Kosho, Hoshino Shouichi, Sugiura Yasushi, Ueshima Dan, Suzuki Naoyuki, Uose Suguru, Nada Takayuki, Kawaguchi Kiyotaka
Department of Gastroenterology & Hepatology, Kitano Hospital, Osaka, Japan.
Intern Med. 2007;46(10):663-7. doi: 10.2169/internalmedicine.46.6115. Epub 2007 May 24.
A 72-year-old man with cough and sputum showed esophageal wall thickening and pneumonia in chest computed tomography (CT) scan. Following endoscopy, we diagnosed reflux esophagitis and subscribed proton pump inhibitor. The esophageal lesion, however, was intractable. We diagnosed microscopic polyangiitis (MPA) because of vasculitis symptoms, cytoplasmic antineutrophil cytoplasmic antibodies (cANCA) in blood and no granulomatous change in the esophagus. We adopted pulse therapy of cyclophosphamide and oral prednisolone; the symptoms and esophageal lesion were markedly improved. We concluded that the esophageal lesion was an aspect of MPA. To our knowledge, this is the first report of esophageal involvement in MPA.
一名72岁男性,有咳嗽和咳痰症状,胸部计算机断层扫描(CT)显示食管壁增厚及肺炎。内镜检查后,我们诊断为反流性食管炎,并给予质子泵抑制剂治疗。然而,食管病变难以治疗。由于存在血管炎症状、血液中出现胞浆型抗中性粒细胞胞浆抗体(cANCA)且食管无肉芽肿性改变,我们诊断为显微镜下多血管炎(MPA)。我们采用了环磷酰胺冲击疗法及口服泼尼松龙;症状及食管病变明显改善。我们得出结论,食管病变是MPA的一个表现。据我们所知,这是关于MPA累及食管的首例报道。