Ozeki Tomonori, Ogasawara Naotaka, Izawa Shinya, Mizuno Mari, Yanamoto Kenichiro, Noda Hisatsugu, Okaniwa Noriko, Tanabe Atsushi, Sasaki Makoto, Kasugai Kunio
Department of Gastroenterology, Aichi Medical University School of Medicine, Japan.
Intern Med. 2013;52(11):1183-7. doi: 10.2169/internalmedicine.52.0232.
A 63-year-old woman was admitted with symptoms of watery diarrhea and generalized edema lasting for five months. She had been administered 15 mg/day of lansoprazole. Laboratory findings revealed severe hypoproteinemia with normal liver, renal, thyroid and adrenal functions and no proteinuria. Colonoscopy revealed edematous mucosa, minor diminished vascular transparency and apparent longitudinal linear lacerations. The histopathological findings were compatible with a diagnosis of collagenous colitis (CC). Protein leakage from the colon was identified on (99m)Tc-human serum albumin scintigraphy. The results indicated CC associated with protein-losing enteropathy. Discontinuing lansoprazole ameliorated the watery diarrhea and generalized edema, increased the serum albumin level and improved the hypoproteinemia.
一名63岁女性因水样腹泻和全身水肿症状入院，症状持续了五个月。她此前每天服用15毫克兰索拉唑。实验室检查结果显示严重低蛋白血症，肝、肾、甲状腺及肾上腺功能正常，且无蛋白尿。结肠镜检查发现黏膜水肿、血管透明度略有降低以及明显的纵向线性撕裂伤。组织病理学检查结果符合胶原性结肠炎（CC）的诊断。（99m）锝-人血清白蛋白闪烁扫描显示结肠有蛋白质渗漏。结果表明CC与蛋白丢失性肠病相关。停用兰索拉唑后，水样腹泻和全身水肿得到改善，血清白蛋白水平升高，低蛋白血症有所改善。
