Zheng Yucan, Kong Guiping, Guo Hongmei, Liu Zhifeng, Yan Kunlong
Department of Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing, China.
Front Immunol. 2025 Jun 9;16:1550551. doi: 10.3389/fimmu.2025.1550551. eCollection 2025.
Behcet's disease (BD) is a lifelong multi-systemic vasculitis disorder that can affect almost any organ. The frequency of involvement of each organ varies depending on demographic and geographical factors. The commonly affected systems include mucosal, articular, ocular, vascular, neurological, and gastrointestinal. Common gastrointestinal manifestations include mucosal ulcers, hemorrhage, and perforation while other phenotypes are very rare.
We describe the case of a 3-year-old boy suffering from BD phenotype with multiple aseptic abscesses (AAs) and interstitial lung disease. Over the past four years since onset, the boy has presented a series of symptoms, including fever, skin necrosis, multiple ulcers in the intestines, multiple aseptic abscesses in the spleen, interstitial lung disease and an isolated abscess in the gastric wall. Through a regimen involving steroids, mercaptopurine, thalidomide endoscopic drainage of the gastric wall abscess, the child's condition has been effectively managed and improved.
To our knowledge, this is the first reported case of BD phenotype with a gastric wall abscess treated with endoscopic drainage and steroids. Multiple AAs and interstitial lung disease may be the early signs of a BD phenotype in childhood which can respond effectively to glucocorticoids.
白塞病(BD)是一种终身性多系统血管炎疾病,几乎可累及任何器官。各器官受累频率因人口统计学和地理因素而异。常见受累系统包括黏膜、关节、眼部、血管、神经和胃肠道。常见的胃肠道表现包括黏膜溃疡、出血和穿孔,而其他表型则非常罕见。
我们描述了一名患有白塞病表型并伴有多发性无菌性脓肿(AA)和间质性肺病的3岁男孩的病例。自发病以来的四年里,该男孩出现了一系列症状,包括发热、皮肤坏死、肠道多发溃疡、脾脏多发性无菌性脓肿、间质性肺病以及胃壁孤立性脓肿。通过使用类固醇、巯嘌呤、沙利度胺以及对胃壁脓肿进行内镜引流的治疗方案,患儿的病情得到了有效控制和改善。
据我们所知,这是首例报道的采用内镜引流和类固醇治疗伴有胃壁脓肿的白塞病表型病例。多发性无菌性脓肿和间质性肺病可能是儿童白塞病表型的早期迹象,对糖皮质激素治疗有效。