Alexander David B, Iigo Masaaki, Abdelgied Mohamed, Ozeki Keiji, Tanida Satoshi, Joh Takashi, Takahashi Satoru, Tsuda Hiroyuki
a Nanotoxicology Project, Nagoya City University, Nagoya, Japan.
b Department of Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Biochem Cell Biol. 2017 Feb;95(1):133-141. doi: 10.1139/bcb-2016-0107. Epub 2016 Nov 30.
A 22-year-old male suffering from abdominal pain, repeated diarrhea, and weight loss visited the Digestive Disease Department of Nagoya City University Hospital on 19 December 2011. He was hospitalized and diagnosed with Crohn's colitis. His Crohn's Disease Activity Index (CDAI) was 415. Treatment by granulocyte apheresis, mesalazine, and adalimumab was started. His CDAI was 314 on 30 December and 215 on 5 January. A colonoscopic examination on 19 January showed almost complete remission in the transverse colon and marked remission in the rectum. Mesalazine therapy was stopped on 28 February, and the patient was instructed to self-inject 40 mg of adalimumab every other week. His CDAI was 50 on 10 April, indicating clinical remission. His last self-injection of adalimumab was on 24 April 2012, and he started taking 1 g of bovine lactoferrin (bLF) daily. His CDAI was 35 on 8 January 2013. He continued taking 1 g of bLF daily without any other treatment for Crohn's disease. Laboratory blood tests on 7 September 2015 showed no sign of disease recurrence, and a colonoscopic examination on 23 October 2015 showed almost complete mucosal healing. This case indicates that ingestion of bLF to maintain Crohn's disease in a remissive state should be further explored.
一名22岁男性,患有腹痛、反复腹泻和体重减轻,于2011年12月19日前往名古屋市立大学医院消化内科就诊。他住院后被诊断为克罗恩结肠炎。他的克罗恩病活动指数(CDAI)为415。开始采用粒细胞单采术、美沙拉嗪和阿达木单抗进行治疗。12月30日他的CDAI为314,1月5日为215。1月19日的结肠镜检查显示横结肠几乎完全缓解,直肠显著缓解。2月28日停止美沙拉嗪治疗,并指示患者每隔一周自行注射40mg阿达木单抗。4月10日他的CDAI为50,表明临床缓解。他最后一次自行注射阿达木单抗是在2012年4月24日,之后他开始每天服用1g牛乳铁蛋白(bLF)。2013年1月8日他的CDAI为35。他继续每天服用1g bLF,未接受任何其他克罗恩病治疗。2015年9月7日的实验室血液检查未显示疾病复发迹象,2015年10月23日的结肠镜检查显示几乎完全黏膜愈合。该病例表明,摄入bLF以维持克罗恩病缓解状态值得进一步研究。