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[慢性腹泻患者并发淋巴细胞性结肠炎和显微镜下肠炎]

[Concurrent lymphocytic colitis and microscopic enteritis in patients with chronic diarrhea].

作者信息

Arévalo Fernando, Vergara Greys, Ruiz Susy, Castillo Joseph, Zurita Fiorella, Monge Eduardo

机构信息

Servicio de Patología, Hospital Nacional Daniel Alcides Carrión. Callao, Perú; Universidad Nacional Mayor de San Marcos. Lima, Perú.

Servicio de Patología, Hospital Nacional Daniel Alcides Carrión. Callao, Perú.

出版信息

Rev Gastroenterol Peru. 2017 Oct-Dec;37(4):340-345.

Abstract

INTRODUCTION

Lymphocytic colitis and microscopic enteritis are relatively common causes of chronic diarrhea and it is characterized by an intraepithelial lymphocytic infiltrate. There have been no previous reports of coexistence between these 2 pathologies.

OBJECTIVE

To describe histological and clinical characteristic in patients with coexistence of lymphocytic colitis and microscopic enteritis.

MATERIAL AND METHODS

All cases with simultaneous diagnosis of lymphocytic duodenosis and lymphocytic colitis were reevaluated during lapse time 2010-2016 in hospital Daniel Carrion. The slides were reviewed by 3 pathologists and clinical information was obtained from clinical records. Expression of CD3 and CD8 was detected in 6 cases by immunohistochemical assays.

RESULTS

A total of 35 patients with coexistence of lymphocytic duodenitis and lymphocytic colitis were selected of the pathology archives, 80% were females, Anemia was identified in 28.5% of patients. Blastocysitis hominis infestation was identified in 31.8%. The mean intraepithelial lymphocyte CD8 and CD3 positive was 40% in microscopic enteritis, while the mean intraepithelial lymphocyte CD3 positive was 37.2% and CD8 positive was 29.2% Additionally, lymphocytic ileitis was diagnosed in 11 of our cases. Eosinophilic colitis was diagnosed in 9 cases of lymphocytic colitis Conclusion: We found that lymphocytic colitis, microscopic enteritis and even lymphocytic ileitis can coexist in a group of patients with chronic diarrhea. These findings bring the question if this concurrence of both pathologies constituted a more generalized gastrointestinal disorder, involving both the large and the small intestines.

摘要

引言

淋巴细胞性结肠炎和显微镜下肠炎是慢性腹泻相对常见的病因,其特征为上皮内淋巴细胞浸润。此前尚无这两种病理状态并存的报道。

目的

描述淋巴细胞性结肠炎和显微镜下肠炎并存患者的组织学和临床特征。

材料与方法

对2010 - 2016年间在丹尼尔·卡里翁医院同时诊断为淋巴细胞性十二指肠炎和淋巴细胞性结肠炎的所有病例进行重新评估。玻片由3名病理学家复查,并从临床记录中获取临床信息。通过免疫组织化学检测6例患者的CD3和CD8表达。

结果

从病理档案中选取了35例淋巴细胞性十二指肠炎和淋巴细胞性结肠炎并存的患者,其中80%为女性,28.5%的患者存在贫血。31.8%的患者检测到人芽囊原虫感染。显微镜下肠炎中上皮内淋巴细胞CD8和CD3阳性的平均值为40%,而上皮内淋巴细胞CD3阳性的平均值为37.2%,CD8阳性的平均值为29.2%。此外,我们的病例中有11例诊断为淋巴细胞性回肠炎。9例淋巴细胞性结肠炎患者诊断为嗜酸性粒细胞性结肠炎。结论:我们发现淋巴细胞性结肠炎、显微镜下肠炎甚至淋巴细胞性回肠炎可在一组慢性腹泻患者中并存。这些发现引发了一个问题,即这两种病理状态的同时出现是否构成一种更广泛的胃肠道疾病,累及大肠和小肠。

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