Hoey Paris, Kaushik Vishal, Francis Leo, Adris Niwansa
Department of Gastroenterology and Hepatology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
Faulty of Medicine, University of Queensland, Brisbane, QLD, Australia.
Clin J Gastroenterol. 2025 Jun;18(3):435-442. doi: 10.1007/s12328-025-02119-w. Epub 2025 Apr 21.
We describe a case of altered bowel habit, early satiety, anorexia and weight loss caused by autoimmune enteropathy. This diagnosis was confirmed by biopsies obtained from upper gastrointestinal endoscopy and ileocolonoscopy. Further investigations revealed multiple pulmonary nodules which were metastases from a malignant thymoma. The patient was commenced on oral budesonide and Mesalazine, in addition to oral and enteral supplementation driven by the specialist nutrition support team, but she did not achieve histological remission, nor did she demonstrate improvement in her nutritional status. She received 3-weeks of in-patient parenteral nutrition, but then subsequently deteriorated as she declined home parenteral nutrition. The patient died eight months later from complications of her disease. This case highlights the rare manifestation of metastatic thymoma presenting with autoimmune enteropathy that led to intestinal failure and death.
我们描述了一例由自身免疫性肠病引起的排便习惯改变、早饱、厌食和体重减轻的病例。通过上消化道内镜检查和回结肠镜检查获取的活检证实了这一诊断。进一步检查发现多个肺结节,为恶性胸腺瘤转移所致。患者开始口服布地奈德和美沙拉嗪,同时由专业营养支持团队提供口服和肠内营养补充,但她未实现组织学缓解,营养状况也未改善。她接受了3周的住院肠外营养,但随后因拒绝家庭肠外营养而病情恶化。患者8个月后死于疾病并发症。该病例突出了转移性胸腺瘤以自身免疫性肠病为表现的罕见情况,这种情况导致了肠衰竭和死亡。