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胸腺切除术后发生自身免疫性肠病的罕见病例。

A Rare Case of Autoimmune Enteropathy After Thymectomy.

作者信息

Patel Arti, Formaker Paul, Abaya Ghazaleh Jonathan, Ajumobi Adewale

机构信息

Internal Medicine, Eisenhower Health, Rancho Mirage, USA.

Graduate Medical Education, Eisenhower Health, Rancho Mirage, USA.

出版信息

Cureus. 2024 Dec 19;16(12):e76020. doi: 10.7759/cureus.76020. eCollection 2024 Dec.

Abstract

Autoimmune enteropathy (AIE) is a rare cause of chronic diarrhea associated with autoantibodies and susceptibility to other autoimmune diseases, such as rheumatoid arthritis, diabetes, autoimmune hemolytic anemia, and atopic dermatitis. While it is more common in children, the prevalence of AIE in adults is increasing. Due to the nonspecific nature of its presenting symptoms and the lack of consistent findings, AIE can be challenging to diagnose. Here, we present a 66-year-old male patient who presented to the emergency department with diarrhea and recurrent bilateral pleural effusions two months after thymoma resection and was eventually diagnosed with AIE. The evaluation revealed blunting of small intestinal villi on biopsy, an IgG staining pattern indicative of circulating anti-enterocyte antibodies, as well as the presence of serum anti-enterocyte and anti-goblet cell antibodies, establishing the diagnosis of AIE.

摘要

自身免疫性肠病(AIE)是慢性腹泻的罕见病因,与自身抗体以及对其他自身免疫性疾病(如类风湿性关节炎、糖尿病、自身免疫性溶血性贫血和特应性皮炎)的易感性相关。虽然它在儿童中更常见,但成人AIE的患病率正在上升。由于其症状表现缺乏特异性且检查结果不一致,AIE的诊断具有挑战性。在此,我们报告一名66岁男性患者,他在胸腺瘤切除术后两个月因腹泻和反复双侧胸腔积液就诊于急诊科,最终被诊断为AIE。评估显示活检时小肠绒毛变钝,IgG染色模式提示存在循环抗肠上皮细胞抗体,以及血清中存在抗肠上皮细胞和抗杯状细胞抗体,从而确诊为AIE。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c1a0/11743685/4f0134f63eb8/cureus-0016-00000076020-i01.jpg

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