Suzuki Hideo, Sato Masashi, Akutsu Daisuke, Sugiyama Hiroaki, Sato Taiki, Mizokami Yuji
Gastrointestinal Endoscopy Division, University of Tsukuba Hospital, Japan.
Department of Gastroenterology and Hepatology,University of Tsukuba Hospital, Japan Daisuke.
J Gastrointestin Liver Dis. 2014 Jun;23(2):203-6. doi: 10.15403/jgld.2014.1121.232.hs1.
We report the case of a 58-year-old woman who was referred to our hospital due to frequent bloody mucus diarrhea. She was diagnosed with cap polyposis based on typical endoscopic and histological findings. Colonoscopy revealed multiple, reddish, mucus-capped polypoid lesions from the rectum to the sigmoid colon. A pathological examination revealed that the polyps were covered by erosive and inflamed granulation tissue with decreased crypt cells. Laboratory data indicated positive values for Helicobacter pylori immunoglobulin G antibody and hypoproteinemia. Metronidazole, H. pylori eradication, and levofloxacin therapies were not effective; however, the subsequent administration of betamethasone enema dramatically improved the clinical symptoms and endoscopic findings. The hypoproteinemia was normalized after the therapy. The dose of the betamethasone enema was tapered gradually, and no recurrence was observed 6 months after discontinuation of the treatment. This case suggests that betamethasone enema may be considered as the second treatment choice for cap polyposis patients after H. pylori eradication, metronidazole or levofloxacin therapy.
我们报告了一例58岁女性患者，因频繁出现血性黏液便而转诊至我院。根据典型的内镜和组织学检查结果，她被诊断为cap息肉病。结肠镜检查发现从直肠到乙状结肠有多个红色、带黏液帽的息肉样病变。病理检查显示息肉被糜烂和发炎的肉芽组织覆盖，隐窝细胞减少。实验室数据显示幽门螺杆菌免疫球蛋白G抗体呈阳性，且存在低蛋白血症。甲硝唑、根除幽门螺杆菌及左氧氟沙星治疗均无效；然而，随后给予倍他米松灌肠显著改善了临床症状和内镜检查结果。治疗后低蛋白血症恢复正常。倍他米松灌肠剂量逐渐减少，停药6个月后未观察到复发。该病例表明，对于cap息肉病患者，在根除幽门螺杆菌、甲硝唑或左氧氟沙星治疗后，倍他米松灌肠可被视为第二治疗选择。
