Hakozaki Yukiya, Mitani Keiji, Okada Chizuko, Terada Hisato, Kobari Shinichi
Department of Internal Medicine, Japan Self Defense Forces Central Hospital, Tokyo, Japan.
Case Rep Gastroenterol. 2013 Mar 13;7(1):122-6. doi: 10.1159/000350320. Print 2013 Jan.
A 51-year-old man was referred for body weight loss and lower right abdominal pain. Total colonoscopy revealed discrete and round ulceration at the ileocecal valve, and he was diagnosed with intestinal Behçet's disease (BD). By treatment with glucocorticoid, colchicine and salazosulfapyridine, the symptoms and ulceration were improved, but cessation of glucocorticoid resulted in relapse of ulceration at the terminal ileum. Long-term, low-dose treatment with clarithromycin (CAM) was implemented for chronic respiratory infections. Furthermore, we expected that this CAM treatment would also be effective in BD. During this long-term, low-dose treatment with CAM, discrete ulceration at the terminal ileum was never revealed by follow-up total colonoscopy once or twice per year for 7 years. No reports have described the effectiveness of this treatment in patients with intestinal BD; however, we confirm that long-term treatment with low-dose CAM might have clinical benefits for patients with intestinal BD.
一名51岁男性因体重减轻和右下腹痛前来就诊。全结肠镜检查显示回盲瓣处有离散的圆形溃疡，他被诊断为肠道白塞病（BD）。通过使用糖皮质激素、秋水仙碱和柳氮磺胺吡啶治疗，症状和溃疡有所改善，但停用糖皮质激素后回肠末端溃疡复发。因慢性呼吸道感染采用克拉霉素（CAM）长期低剂量治疗。此外，我们预期这种CAM治疗对BD也有效。在进行这种CAM长期低剂量治疗期间，连续7年每年进行一到两次全结肠镜随访，从未发现回肠末端有离散溃疡。尚无报道描述这种治疗对肠道BD患者的有效性；然而，我们证实低剂量CAM长期治疗可能对肠道BD患者有临床益处。
