Gamboa-Domínguez A, Velázquez Ceceña J L, Reyes-Gutiérrez E
Departamento de Patología, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.
Rev Invest Clin. 1995 Jul-Aug;47(4):303-9.
Neutropenic enterocolitis (NE) is a serious complication in neutropenic patients; it often affects the cecum and the ascending colon. Most cases have been reported in neutropenic patients after chemotherapy for hematologic neoplasms, and some in association with conditions such as rheumatoid arthritis, benign cyclic neutropenia, and solid neoplasms. As far as we know, four cases of NE associated to AA (aplastic anemia, hypoplastic bone marrow) have been previously reported, two of them with autopsy studies. The macroscopic findings in the enterocolonic lesions were not illustrated. We report the first two cases in Mexico. The NE was neither clinically nor radiographically suspected initially, i.e. the morphologic diagnosis of their colonic lesions were amebic colitis in one and edematous ulcerated colitis in the other. Medical treatment without surgery was instituted. Both died. The macroscopic aspect of the enterocolonic lesions in NE associated to aplastic anemia in our two patients was similar to that in NE associated to hematologic neoplasms. In Mexico there is little experience in the clinical, radiographic or morphologic diagnosis of this rare association.
中性粒细胞减少性小肠结肠炎（NE）是中性粒细胞减少患者的一种严重并发症；它常累及盲肠和升结肠。大多数病例报道于血液系统肿瘤化疗后的中性粒细胞减少患者，也有一些与类风湿关节炎、良性周期性中性粒细胞减少症和实体肿瘤等疾病相关。据我们所知，此前已有4例与再生障碍性贫血（AA，再生障碍性贫血、骨髓发育不良）相关的NE病例报道，其中2例进行了尸检研究。未对小肠结肠病变的宏观表现进行描述。我们报告墨西哥的首例2例病例。最初临床和影像学检查均未怀疑为NE，即其中1例结肠病变的形态学诊断为阿米巴结肠炎，另1例为水肿性溃疡性结肠炎。采取了非手术的药物治疗。两人均死亡。我们两名患者中与再生障碍性贫血相关的NE的小肠结肠病变的宏观表现与血液系统肿瘤相关的NE相似。在墨西哥，对于这种罕见关联的临床、影像学或形态学诊断经验很少。
