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[第462例:慢性水样腹泻伴急性肾损伤]

[The 462nd case: chronic watery diarrhea and acute kidney injury].

作者信息

Ni Y H, Li J, Zhou W X, Luo Y P, Jiang Q W, Liu Y, Yue C, Sun G, Qian J M

机构信息

Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2018 Apr 1;57(4):309-312. doi: 10.3760/cma.j.issn.0578-1426.2018.04.018.

Abstract

A 60-year-old man presented with severe watery diarrhea for 2 months complicated with weight loss and acute kidney injury. He did not respond well to antidiarrheal medicines, empirical antibiotics and dietary exclusion of gluten or even complete bowel rest. The final diagnosis of autoimmune enteropathy (AIE) was made based on histopathologic findings of endoscopic biopsy from duodenal mucosa after excluding neoplastic disease, inflammatory bowel disease, and infectious diarrhea, etc. Chronic diarrhea and oliguria alleviated after the administration of corticosteroids.

摘要

一名60岁男性出现严重水样腹泻2个月,伴有体重减轻和急性肾损伤。他对抗腹泻药物、经验性使用抗生素以及饮食中排除麸质甚至完全肠道休息均反应不佳。在排除肿瘤性疾病、炎症性肠病和感染性腹泻等后,根据十二指肠黏膜内镜活检的组织病理学结果确诊为自身免疫性肠病(AIE)。给予糖皮质激素治疗后,慢性腹泻和少尿症状缓解。

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