Wei Hongyun, Ouyang Chunhui, Peng Dehong, Lu Fanggen, Zhang Jie
Department of Gastroenterology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, P.R. China.
Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, P.R. China.
Exp Ther Med. 2018 Apr;15(4):3997-4000. doi: 10.3892/etm.2018.5910. Epub 2018 Feb 28.
The present case report details a rare case of osteoporosis as the initial manifestation of Crohn's disease (CD). A 43-year-old male was referred to the Second Xiangya Hospital of Central South University (Changsha, China) for further examination of low back pain (LBP) without digestive symptoms. Bone mineral density (BMD) analysis indicated osteoporosis, particularly in the lumbar spine. Endoscopy revealed an inflamed and strictured ileocecal valve with less inflammation in the ascending, transverse colon, sigmoid colon and rectum, compatible with CD, which was in accordance with the appearance of an abdominal computed tomography scan. Duodenal-balloon enteroscopy indicated segmental ulceration and stricture in the jejunum, in accordance with CD. The patient was diagnosed with CD following examination. It was suspected that osteoporosis may be an extra-intestinal manifestation of CD. Steroids and biological agents were prescribed in sequence. LBP and BMD rapidly improved following treatment, and inflammatory markers returned to normal after 1.5 years of treatment. According to this case, osteoporosis with unknown causes should be considered as a possible sign of small intestinal CD.
本病例报告详细介绍了一例罕见的以骨质疏松为克罗恩病（CD）初始表现的病例。一名43岁男性因无消化系统症状的腰痛（LBP）被转诊至中南大学湘雅二医院（中国长沙）进行进一步检查。骨密度（BMD）分析显示骨质疏松，尤其是腰椎。内镜检查发现回盲瓣发炎并狭窄，升结肠、横结肠、乙状结肠和直肠炎症较轻，符合CD表现，这与腹部计算机断层扫描结果一致。十二指肠球囊小肠镜检查显示空肠节段性溃疡和狭窄，符合CD表现。经检查，该患者被诊断为CD。怀疑骨质疏松可能是CD的肠外表现。依次开具了类固醇和生物制剂。治疗后LBP和BMD迅速改善，治疗1.5年后炎症标志物恢复正常。根据该病例，原因不明的骨质疏松应被视为小肠CD的可能迹象。
