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原因还是结果？一名克罗恩病患者维生素D水平检测不到

Cause or effect? Undetectable vitamin D in a patient with Crohn's disease.

作者信息

Esswein Julia, Vickers Maggie, Kleinman Michael, Whitworth John, Corkins Mark, Riley Pace S

机构信息

Division of Internal Medicine and Pediatrics University of Tennessee Health Sciences Center Memphis Tennessee USA.

Division of Gastroenterology LeBonheur Children's Hospital Memphis Tennessee USA.

出版信息

JPGN Rep. 2024 Feb 8;5(2):194-196. doi: 10.1002/jpr3.12045. eCollection 2024 May.

DOI:10.1002/jpr3.12045
PMID:38756124
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11093929/
Abstract

Crohn's disease has been described as the "great mimicker" with a wide array of presentations. We describe a case of a teenager who presented with tetany and undetectable vitamin D as initial presentation of Crohn's disease. There are reports of adults in tetany due to electrolyte derangements in chronic gastrointestinal diseases secondary to malabsorption. However, the role of deficient vitamin D as it contributes to immune system dysfunction has only begun to be explored. Vitamin D is essential for calcium absorption, immune regulation, and gut epithelial barrier. This case report discusses vitamin D physiology and its potential mediation in the pathogenesis of inflammatory bowel disease.

摘要

克罗恩病被称为“伟大的模仿者”，临床表现多种多样。我们描述了一例青少年病例，该患者最初表现为手足搐搦且维生素D检测不到，这是克罗恩病的首发症状。有报道称，成年人因慢性胃肠疾病继发吸收不良导致电解质紊乱而出现手足搐搦。然而，维生素D缺乏在导致免疫系统功能障碍方面的作用才刚刚开始被探索。维生素D对钙吸收、免疫调节和肠道上皮屏障至关重要。本病例报告讨论了维生素D的生理学及其在炎症性肠病发病机制中的潜在介导作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b375/11093929/ca7aa4d9a4f8/JPR3-5-194-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b375/11093929/5233abda3161/JPR3-5-194-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b375/11093929/ca7aa4d9a4f8/JPR3-5-194-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b375/11093929/5233abda3161/JPR3-5-194-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b375/11093929/ca7aa4d9a4f8/JPR3-5-194-g001.jpg

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本文引用的文献

1
The endocrine vitamin D system in the gut.肠道中的内分泌维生素D系统。
Mol Cell Endocrinol. 2017 Sep 15;453:79-87. doi: 10.1016/j.mce.2016.11.028. Epub 2016 Nov 29.
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Antimicrobial cathelicidin peptide LL-37 inhibits the LPS/ATP-induced pyroptosis of macrophages by dual mechanism.抗菌肽 LL-37 通过双重机制抑制 LPS/ATP 诱导的巨噬细胞焦亡。
PLoS One. 2014 Jan 16;9(1):e85765. doi: 10.1371/journal.pone.0085765. eCollection 2014.
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Vitamin D3 down-regulates monocyte TLR expression and triggers hyporesponsiveness to pathogen-associated molecular patterns.维生素D3下调单核细胞Toll样受体（TLR）的表达，并引发对病原体相关分子模式的低反应性。
Eur J Immunol. 2006 Feb;36(2):361-70. doi: 10.1002/eji.200425995.
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Toll-like receptors 2 and 4 are up-regulated during intestinal inflammation.Toll样受体2和4在肠道炎症期间上调。
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Nature. 2000 Aug 17;406(6797):782-7. doi: 10.1038/35021228.