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[伴有胃炎、十二指肠溃疡和结肠炎的难治性嗜酸性粒细胞性胃肠炎:一例报告]

[Refractory eosinophilic gastroenteritis with gastritis, duodenal ulcer, and colitis: a case report].

作者信息

Miura Yuko, Iwamoto Fumihiko, Ishida Yasuaki, Kuno Toru, Tanaka Keisuke, Kobayashi Shoji, Yoshida Takashi, Yamaguchi Tatsuya, Sato Tadashi, Enomoto Nobuyuki

机构信息

First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi.

出版信息

Nihon Shokakibyo Gakkai Zasshi. 2019;116(8):668-675. doi: 10.11405/nisshoshi.116.668.

Abstract

Eosinophilic gastroenteritis is a rare disease that causes various abdominal symptoms that result from the infiltration of eosinophils in the digestive tract. However, this condition has been poorly explored, and the treatment criteria and prognosis after treatment are still unclear. A 20-year-old man with a refractory duodenal ulcer had been undergoing treatment since 14 years of age at another hospital. He was admitted to our hospital with abdominal pain and anemia (hemoglobin:6.3g/dL). His blood test showed elevated serum immunoglobulin E levels, considering that he was allergic to many foods. Furthermore, endoscopic biopsy detected the occurrence of eosinophilic gastroenteritis with gastritis, duodenal ulcer, and colitis. We treated him by avoiding allergenic foods and prescribing antihistamine and vonoprazan;however, duodenal ulcer and gastrointestinal tract inflammation did not show improvement. Thus, he was diagnosed with wide-ranging and refractory eosinophilic gastroenteritis and treated with 40mg/day of steroids. After 2 months, he recovered from gastritis and duodenal ulcer, and his eosinophil level decreased, as assessed using endoscopic biopsy. Eosinophilic gastroenteritis is poorly investigated, and its treatment standards have not yet been determined. Nonetheless, steroid treatment is often applied in severe cases.

摘要

嗜酸性胃肠炎是一种罕见疾病,由嗜酸性粒细胞浸润消化道导致各种腹部症状。然而,这种疾病尚未得到充分研究,治疗标准和治疗后的预后仍不明确。一名患有难治性十二指肠溃疡的20岁男性自14岁起就在另一家医院接受治疗。他因腹痛和贫血(血红蛋白:6.3g/dL)入住我院。他的血液检查显示血清免疫球蛋白E水平升高,考虑到他对多种食物过敏。此外,内镜活检发现患有嗜酸性胃肠炎,伴有胃炎、十二指肠溃疡和结肠炎。我们通过避免食用致敏食物并开具抗组胺药和沃克奥美拉唑对他进行治疗;然而,十二指肠溃疡和胃肠道炎症并未改善。因此,他被诊断为广泛性难治性嗜酸性胃肠炎,并接受了每天40mg的类固醇治疗。2个月后,他的胃炎和十二指肠溃疡康复,内镜活检评估显示嗜酸性粒细胞水平下降。嗜酸性胃肠炎的研究尚不充分,其治疗标准尚未确定。尽管如此,类固醇治疗在严重病例中经常应用。

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