Izumikawa Koichi, Motoi Noriko, Takaya Hisashi, Miyamoto Atsushi, Eishi Yoshinobu, Yoshimura Kunihiko, Kishi Kazuma
Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital, Japan.
Intern Med. 2011;50(23):2915-7. doi: 10.2169/internalmedicine.50.5298. Epub 2011 Dec 1.
A 24-year-old man was referred to our hospital due to bilateral hilar lymphadenopathy on chest radiography. He had been under medication for aortitis syndrome and Crohn's disease for 12 years. Surgical biopsy from the anterior segment of the left upper lobe and mediastinal lymph nodes was performed under video-assisted thoracoscopy. Histopathological examination revealed epithelioid cell granulomas without caseous necrosis, compatible with sarcoidosis. Full sequence analysis of the CARD15 gene, which is reportedly related to the formation of granulomatous lesions in Crohn's disease and sarcoidosis revealed no mutation of CARD15 gene. This is the first report of concurrent sarcoidosis, Crohn's disease and aortitis syndrome in an individual.
一名24岁男性因胸部X线检查发现双侧肺门淋巴结肿大而被转诊至我院。他因大动脉炎综合征和克罗恩病接受药物治疗已达12年。在电视辅助胸腔镜下对左上叶前段和纵隔淋巴结进行了手术活检。组织病理学检查显示为上皮样细胞肉芽肿,无干酪样坏死,符合结节病表现。据报道与克罗恩病和结节病中肉芽肿性病变形成相关的CARD15基因全序列分析显示,该基因无突变。这是关于个体同时患有结节病、克罗恩病和大动脉炎综合征的首例报告。