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接触性变应性胃炎:一种诊断不足的疾病?

Contact allergic gastritis: an underdiagnosed entity?

作者信息

Pföhler Claudia, Körner Rebecca, Vogt Thomas, Müller Cornelia S L

机构信息

Department of Dermatology, Saarland University Hospital, Homburg/Saar, Germany.

出版信息

BMJ Case Rep. 2012 Nov 28;2012:bcr2012006916. doi: 10.1136/bcr-2012-006916.

Abstract

Only a few cases of contact allergic gastritis in patients with nickel allergy have been reported. We report a case of probable contact-allergic gastritis in a 46-year-old woman. Clinical examination revealed lichenoid mucosal lesions of the gums adjacent to bridges and crowns that had been implanted several weeks back. Since implantation, the patient had suffered from gastrointestinal complaints (including stomach pain). Gastroscopy showed eosinophilic gastritis. Patch testing done under the diagnosis of contact allergic stomatitis showed positive reactions to: gold sodium thiosulphate; manganese (II) chloride; nickel (II) sulphate; palladium chloride; vanadium (III) chloride and zirconium (IV) chloride. The crowns and bridge contained gold, palladium and zirconium chloride, hence they were replaced by titan-based dentition. Shortly after replacing the artificial dentition, all gastrointestinal symptoms resolved spontaneously without further treatment. Delayed-type allergy against the components of artificial dentition seemed to be the cause of gastritis.

摘要

仅有少数镍过敏患者发生接触性变应性胃炎的病例报告。我们报告一例46岁女性可能患有接触性变应性胃炎的病例。临床检查发现,在几周前植入的牙桥和牙冠附近的牙龈出现苔藓样黏膜病变。自植入以来,患者一直有胃肠道不适症状(包括胃痛)。胃镜检查显示为嗜酸性胃炎。在接触性变应性口炎诊断下进行的斑贴试验显示对以下物质呈阳性反应:硫代硫酸金钠;氯化锰(II);硫酸镍(II);氯化钯;氯化钒(III)和氯化锆(IV)。牙冠和牙桥含有金、钯和氯化锆,因此将它们更换为钛基牙列。更换人工牙列后不久,所有胃肠道症状未经进一步治疗便自行缓解。对人工牙列成分的迟发型过敏似乎是胃炎的病因。

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Contact allergic gastritis: an underdiagnosed entity?接触性变应性胃炎:一种诊断不足的疾病?
BMJ Case Rep. 2012 Nov 28;2012:bcr2012006916. doi: 10.1136/bcr-2012-006916.
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