Singh Ayaskanta
Department of Gastroenterology and Hepatobiliary Sciences, IMS and SUM Hospital, Siksha 'O' Anusandhan, deemed to be University, Kalinga Nagar, Bhubaneswar, Orissa, 751003, India.
Curr Gastroenterol Rep. 2019 Sep 10;21(10):53. doi: 10.1007/s11894-019-0721-6.
The purpose is to make aware of the existence of the rare and exclusive small intestine (SI) diseases, namely cryptogenic multifocal ulcerating stenosing enteropathy (CMUSE) or chronic non-specific multiple ulcers of the small intestine (CNSU) and non-granulomatous ulcerating jejunoileitis (NGUJI). The article will elucidate their epidemiology, pathogenesis, clinical features, diagnosis, differentiating features and management.
Recent papers have published the clinical features and diagnostic criteria of CMUSE/CNSU and NGUJI. CNSU/CMUSE is caused by gene mutations involved in the prostaglandin pathways. Although capsule endoscopy can detect these lesions, it carries a risk of retention. TNF antagonists and azathioprine have shown response in few cases. CMUSE/CNSU and NGUJI are uncommon diseases that cause relapsing SI obstruction and bleed due to short-segment strictures and multiple shallow ulcers. This article focuses on current knowledge and novel insights regarding their pathogenesis, genetics, clinical features, diagnostic criteria and management. Multicentric clinical and genetic studies are the need of the hour.
目的是让人们了解罕见且独特的小肠疾病,即隐源性多灶性溃疡性狭窄性小肠炎(CMUSE)或慢性非特异性小肠多发性溃疡(CNSU)以及非肉芽肿性溃疡性空回肠炎(NGUJI)。本文将阐明它们的流行病学、发病机制、临床特征、诊断、鉴别特征及治疗方法。
近期论文发表了CMUSE/CNSU和NGUJI的临床特征及诊断标准。CNSU/CMUSE由前列腺素途径相关基因突变引起。虽然胶囊内镜可检测到这些病变,但存在滞留风险。肿瘤坏死因子拮抗剂和硫唑嘌呤在少数病例中显示有效。CMUSE/CNSU和NGUJI是罕见疾病,因短节段狭窄和多发浅溃疡导致复发性小肠梗阻和出血。本文重点关注其发病机制、遗传学、临床特征、诊断标准及治疗方法的现有知识和新见解。多中心临床和遗传学研究是当务之急。