Beppu Kazuko, Osada Taro, Inoue Kanako, Matsumoto Kenshi, Shibuya Tomoyoshi, Sakamoto Naoto, Kawabe Masato, Nagahara Akihito, Ogihara Tatsuo, Watanabe Sumio
Department of Gastroenterology, Juntendo University, School of Medicine, Japan.
Intern Med. 2011;50(3):219-22. doi: 10.2169/internalmedicine.50.4188. Epub 2011 Feb 1.
Wegener's granulomatosis (WG) is a multisystemic disease of unknown etiology characterized by necrotizing vasculitis and granulomatous inflammation (1-3). The disease typically involves the upper airways, lungs and kidneys, and gastrointestinal involvement is uncommon. Described here is a 33-year-old man who presented at the hospital with abdominal pain. Colonoscopy revealed multiple ulcers, including round ulcers, throughout the large intestine. Small bowel ulcers were detected by double balloon enteroscopy (DBE). Further study confirmed that these ulcers were caused by gastrointestinal complications of WG. The patient was administered prednisolone and cyclophosphamide and remains in remission. This case indicates the importance of considering a gastrointestinal complication of WG as the potential cause of abdominal symptoms among WG patients as well as the use of DBE in detecting such a complication.
韦格纳肉芽肿病(WG)是一种病因不明的多系统疾病,其特征为坏死性血管炎和肉芽肿性炎症(1 - 3)。该病通常累及上呼吸道、肺部和肾脏,胃肠道受累并不常见。本文描述了一名33岁男性,因腹痛入院。结肠镜检查发现整个大肠有多个溃疡,包括圆形溃疡。双气囊小肠镜(DBE)检测到小肠溃疡。进一步检查证实这些溃疡是由WG的胃肠道并发症引起的。该患者接受了泼尼松龙和环磷酰胺治疗,目前仍处于缓解期。此病例表明,对于WG患者,将WG的胃肠道并发症视为腹部症状的潜在病因以及使用DBE检测此类并发症具有重要意义。