Mizoguchi Akinori, Higashiyama Masaaki, Ikeyama Keisuke, Nishii Shin, Terada Hisato, Furuhashi Hirotaka, Takajo Takeshi, Maruta Koji, Yasutake Yuichi, Shirakabe Kazuhiko, Watanabe Chikako, Tomita Kengo, Komoto Shunsuke, Nagao Shigeaki, Miura Soichiro, Hokari Ryota
Department of Internal Medicine, National Defense Medical College, Japan.
Intern Med. 2018 Jan 1;57(1):37-41. doi: 10.2169/internalmedicine.8993-17. Epub 2017 Oct 16.
We herein describe a 69-year-old man suffering from chronic diarrhea caused by lansoprazole (LPZ)-induced collagenous colitis (CC) accompanied with protein-losing enteropathy (PLE), diagnosed by increased fecal alpha-1 antitrypsin clearance and the findings of leakage from the descending colon to the sigmoid colon on scintigraphy. MR enterocolonography (MREC) was also performed for differentiating digestive diseases, and inflamed findings were observed around the same portion as those on scintigraphy, suggesting that this region was responsible for protein loss in this case. The MREC findings improved after the cessation of LPZ, and hypoalbuminemia also improved simultaneously. This case suggests that MREC may be a new and useful diagnostic tool for CC with PLE.
我们在此描述一名69岁男性，他患有由兰索拉唑（LPZ）诱导的胶原性结肠炎（CC）伴蛋白丢失性肠病（PLE）引起的慢性腹泻，通过粪便α-1抗胰蛋白酶清除率增加以及闪烁扫描显示降结肠至乙状结肠有渗漏而确诊。还进行了磁共振小肠结肠成像（MREC）以鉴别消化系统疾病，在与闪烁扫描相同的部位观察到炎症表现，提示该区域是本例蛋白丢失的原因。停用LPZ后MREC表现改善，同时低蛋白血症也得到改善。该病例表明MREC可能是一种用于诊断伴有PLE的CC的新型且有用的诊断工具。
