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溃疡性结肠炎伴腹泻加重的鉴别诊断；胶原性结肠炎或肠易激综合征？病例报告。

Differential diagnosis of ulcerative colitis with increased diarrhea; collagenous colitis or irritable bowel syndrome? A case report.

机构信息

Department of Gastroenterology, Juntendo University School of Medicine, 3-1-1 Hongo, Bunkyo-ku, Tokyo, Japan.

Department of Human Pathology, Juntendo University School of Medicine, 3-1-1 Hongo, Bunkyo-ku, Tokyo, Japan.

出版信息

J Int Med Res. 2022 Dec;50(12):3000605221140686. doi: 10.1177/03000605221140686.

DOI:10.1177/03000605221140686
PMID:36474409
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9732797/
Abstract

A 50-year-old man with a 20-year history of left-sided ulcerative colitis (UC) presented to our hospital with sudden onset of watery diarrhea. To this point, he had been treated with mesalazine 2.0 g/day for UC and had maintained remission. We considered that the UC had worsened. We immediately performed surveillance colonoscopy, which revealed a normal mucous membrane. The results of blood laboratory examinations were normal. Histopathology of colonic biopsies revealed new-onset collagenous colitis (CC), with a thickened subepithelial collagen band (SECB) and inactive UC. We herein report the importance of random colonic biopsies to diagnose CC even when the endoscopic appearance of the colon is normal in patients with inflammatory bowel disease with worsened diarrhea.

摘要

一位 50 岁男性，有 20 年左侧溃疡性结肠炎（UC）病史，因突发水样腹泻就诊于我院。此前，他一直接受美沙拉嗪 2.0g/天治疗，病情缓解。我们考虑 UC 加重，立即行监测性结肠镜检查，结果示黏膜正常。血液实验室检查结果正常。结肠活检组织病理学检查显示新发胶原性结肠炎（CC），黏膜下层胶原带增厚（SECB）和活动性 UC 缓解。本研究报告了即使炎症性肠病患者腹泻加重时结肠镜表现正常，随机结肠活检对诊断 CC 的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94e5/9732797/8ba92e5e6600/10.1177_03000605221140686-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94e5/9732797/b5871197b4f4/10.1177_03000605221140686-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94e5/9732797/c308d3fbe91a/10.1177_03000605221140686-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94e5/9732797/8ba92e5e6600/10.1177_03000605221140686-fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94e5/9732797/b5871197b4f4/10.1177_03000605221140686-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94e5/9732797/c308d3fbe91a/10.1177_03000605221140686-fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94e5/9732797/8ba92e5e6600/10.1177_03000605221140686-fig3.jpg

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本文引用的文献

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Microscopic colitis in older adults: impact, diagnosis, and management.老年患者的显微镜下结肠炎：影响、诊断与管理
Ther Adv Chronic Dis. 2022 Jul 5;13:20406223221102821. doi: 10.1177/20406223221102821. eCollection 2022.
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Changes in Salivary Parameters of Oral Immunity after Biologic Therapy for Inflammatory Bowel Disease.炎症性肠病生物治疗后口腔免疫唾液参数的变化
Life (Basel). 2021 Dec 16;11(12):1409. doi: 10.3390/life11121409.
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Controversials of Microscopic Colitis.显微镜下结肠炎的争议
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Potential Salivary Markers for Differential Diagnosis of Crohn's Disease and Ulcerative Colitis.用于克罗恩病和溃疡性结肠炎鉴别诊断的潜在唾液标志物
Life (Basel). 2021 Sep 9;11(9):943. doi: 10.3390/life11090943.
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Leucine-rich alpha-2 glycoprotein is a potential biomarker to monitor disease activity in inflammatory bowel disease receiving adalimumab: PLANET study.富含亮氨酸的α-2 糖蛋白是监测接受阿达木单抗治疗的炎症性肠病疾病活动的潜在生物标志物：PLANET 研究。
J Gastroenterol. 2021 Jun;56(6):560-569. doi: 10.1007/s00535-021-01793-0. Epub 2021 May 3.
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A Practical Guide for Faecal Calprotectin Measurement: Myths and Realities.《粪便钙卫蛋白检测实用指南：误区与真相》。
J Crohns Colitis. 2021 Jan 13;15(1):152-161. doi: 10.1093/ecco-jcc/jjaa093.
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Development of collagenous colitis in inflammatory bowel disease: two case reports and a review of the literature.炎症性肠病中胶原性结肠炎的发生：两例病例报告及文献综述
Gastroenterol Rep (Oxf). 2019 Jun;7(3):218-222. doi: 10.1093/gastro/gox026. Epub 2017 Jul 19.
8
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Med Hypotheses. 2019 Feb;123:90-94. doi: 10.1016/j.mehy.2019.01.004. Epub 2019 Jan 7.
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Inflamm Bowel Dis. 2018 Nov 29;24(12):2590-2598. doi: 10.1093/ibd/izy266.
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Gastroenterol Res Pract. 2018 May 24;2018:4203737. doi: 10.1155/2018/4203737. eCollection 2018.