Schön Klinik Hamburg-Eilbek, Hamburg, Germany.
Inselspital Universitätsspital Bern, Switzerland.
Z Gastroenterol. 2021 Apr;59(4):326-330. doi: 10.1055/a-1310-4500. Epub 2021 Apr 12.
T-lymphocytic enteral leiomyositis (T-lel) is a rare disorder causing chronic intestinal pseudo-obstruction (CIPO), with cases predominantly being reported in the field of veterinary and pediatric medicine. Here, we present a case of T-lel-associated CIPO in an adult female, who initially presented with a paralytic ileus 2 weeks after a common gastroenteritis. The histological diagnosis was established through full-thickness bowel biopsy, exhibiting a dense lymphocytic infiltrate in the lamina muscularis of the intestinal wall. This case shows that T-lel can be a cause of chronic intestinal pseudo-obstruction not only in children but also in adults. A subsequent induction of an immunosuppressive therapy with steroids, azathioprine, and ultimately TNF-alpha-inhibiting antibodies led to a slow recovery and stable disease.
T 淋巴细胞性肠肌层肌瘤（T-lel）是一种罕见的疾病，可导致慢性肠假性梗阻（CIPO），主要在兽医和儿科医学领域报告有病例。在此，我们报告了一例成人女性 T-lel 相关 CIPO，其最初在普通胃肠炎后 2 周出现麻痹性肠梗阻。通过全层肠活检作出了组织学诊断，显示肠壁肌层有密集的淋巴细胞浸润。该病例表明，T-lel 不仅可引起儿童慢性肠假性梗阻，也可引起成人慢性肠假性梗阻。随后采用类固醇、巯嘌呤和最终 TNF-α 抑制剂诱导免疫抑制治疗，导致缓慢恢复和疾病稳定。
