Division of Metabolism and Biosystemic Science, Gastroenterology, and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Japan.
Department of Diagnostic Pathology, Asahikawa Medical University Hospital, Japan.
Intern Med. 2023 Jan 1;62(1):69-74. doi: 10.2169/internalmedicine.9590-22. Epub 2022 May 21.
A 24-year-old woman was admitted to our hospital due to abdominal pain and a high fever. She was diagnosed with ileocolonic Crohn's disease (CD), complicated with a gastro-colic fistula and splenomegaly. After initial treatment with an infliximab-biosimilar, all blood cell line counts markedly decreased. Three-dimensional reconstructed computed tomography revealed splenic vein narrowing. Thus, her pancytopenia was deemed to have likely been caused by hypersplenism. Surgery was performed, and clinical remission was maintained without pancytopenia. This is the first report of a CD patient with pancytopenia caused by hypersplenism that was triggered by gastro-colic fistula-associated splenic vein obstruction.
一位 24 岁女性因腹痛和高热被收入我院。她被诊断为回肠结肠型克罗恩病（CD），并发胃肠结肠瘘和脾肿大。初始使用英夫利昔单抗生物类似药治疗后，所有血细胞计数明显下降。三维重建计算机断层扫描显示脾静脉狭窄。因此，认为她的全血细胞减少可能是由脾功能亢进引起的。进行了手术，并且在没有全血细胞减少的情况下维持了临床缓解。这是首例由胃肠结肠瘘相关脾静脉阻塞引起的脾功能亢进导致 CD 患者全血细胞减少的报告。
