Lim Kyung In, Yang Dong Hwa, Ryoo Eell
Department of Pediatrics, Gachon University Gil Hospital, Incheon, Korea.
Intest Res. 2017 Jul;15(3):422-428. doi: 10.5217/ir.2017.15.3.422. Epub 2017 Jun 12.
We report the case of a 5-year-old male patient with multiple aseptic splenic abscesses associated with Behçet's disease. The patient visited Gachon University Gil Hospital with fever, abdominal pain, and acute watery and bloody diarrhea, and reported a 2-year history of chronic abdominal pain and intermittent watery diarrhea. He was treated with antibiotics at a local clinic for fever and cervical lymph node swelling. Additionally, he had recurrent stomatitis. A colonoscopy showed multiple well-demarcated ulcerations throughout the colon, and abdominal computed tomography showed multiple splenic abscesses. Pathergy and HLA-B51 tests were positive. Investigations did not reveal any infectious organisms in the aspirate obtained via ultrasound-guided fine needle aspiration. After steroid treatment, all symptoms and multiple aseptic splenic abscesses resolved. However, oral ulcers, genital ulcers, and abdominal pain recurred after tapering the steroids. Infliximab treatment improved the patient's symptoms. However, 5 months after the treatment, the symptoms recurred. The treatment was changed to include adalimumab. Subsequently, the patient's symptoms resolved and colonoscopic findings improved. No recurrence was noted after 3 months of follow-up.
我们报告了一例5岁男性患者，患有与白塞病相关的多发性无菌性脾脓肿。该患者因发热、腹痛以及急性水样和血性腹泻就诊于嘉泉大学吉尔医院，并有2年慢性腹痛和间歇性水样腹泻病史。他曾在当地诊所接受抗生素治疗发热和颈部淋巴结肿大。此外，他有复发性口腔炎。结肠镜检查显示整个结肠有多个界限清楚的溃疡，腹部计算机断层扫描显示多个脾脓肿。针刺反应和HLA - B51检测呈阳性。通过超声引导下细针穿刺获取的抽吸物检查未发现任何感染性生物体。经类固醇治疗后，所有症状和多发性无菌性脾脓肿均消退。然而，在逐渐减少类固醇剂量后，口腔溃疡、生殖器溃疡和腹痛复发。英夫利昔单抗治疗改善了患者症状。然而，治疗5个月后症状复发。治疗改为使用阿达木单抗。随后，患者症状消退，结肠镜检查结果改善。随访3个月未发现复发。
