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一名女性青少年铁剂所致胃炎的罕见病例:病例报告及文献综述

A rare case of iron-pill induced gastritis in a female teenager: A case report and a review of the literature.

作者信息

Meliţ Lorena Elena, Mărginean Cristina Oana, Mocanu Simona, Mărginean Maria Oana

机构信息

Department of Pediatrics I, University of Medicine and Pharmacy Department of Pathology, County Hospital, Tîrgu Mureş, Romania.

出版信息

Medicine (Baltimore). 2017 Jul;96(30):e7550. doi: 10.1097/MD.0000000000007550.

Abstract

RATIONALE

The treatment of iron-deficiency anemia with oral iron supplements can present side-effects on the GI tract mucosa including necrosis, ulceration, or ischemia. The particular endoscopic findings and the histopathological exam will establish the diagnosis of erosive gastritis with iron deposits in the gastric mucosa.

PATIENT CONCERNS

We present the case of a 14-year-old female admitted in our clinic for upper digestive hemorrhage, nausea, melena, and abdominal pain. Her personal history revealed iron deficiency anemia receiving oral iron supplements for approximately 2 weeks.

DIAGNOSIS

The laboratory tests at the moment of admission pointed out anemia, increased level of serum iron, increased liver transaminases, a decreased level of ferritin, but with normal levels of both total iron-binding capacity and transferrin.

INTERVENTIONS

The eso-gastro-duodenoscopy revealed multiple brown deposits on the surface of the gastric mucosa and multiple hemorrhagic lesions, under the aspect of erosions all over the gastric mucosa, but more severe in the antral part, and the histopathological exam confirmed the presence of iron deposits at this level.

CONCLUSION

Iron-pill induced gastritis is a rare, under-diagnosed entity that can be present even at pediatric ages with potential severe clinical impact.

摘要

原理

口服铁补充剂治疗缺铁性贫血可能会对胃肠道黏膜产生副作用,包括坏死、溃疡或缺血。特定的内镜检查结果和组织病理学检查将确诊为胃黏膜有铁沉积的糜烂性胃炎。

患者情况

我们报告了一名14岁女性患者的病例,她因上消化道出血、恶心、黑便和腹痛入住我院。她的个人病史显示患有缺铁性贫血,口服铁补充剂约2周。

诊断

入院时的实验室检查显示贫血、血清铁水平升高、肝转氨酶升高、铁蛋白水平降低,但总铁结合能力和转铁蛋白水平正常。

干预措施

食管胃十二指肠镜检查发现胃黏膜表面有多处棕色沉积物和多处出血性病变,整个胃黏膜均有糜烂表现,但胃窦部更严重,组织病理学检查证实该部位存在铁沉积。

结论

铁剂所致胃炎是一种罕见的、诊断不足的疾病,甚至在儿童期也可能出现,具有潜在的严重临床影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dc84/5627827/fb8843d1f1d8/medi-96-e7550-g001.jpg

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