Drake W M, Winter T A, Price S K, O'Keefe S J
Department of Gasiroenterology, Groote Schuur Hospital, University of Cape Town, Observatory, South Africa.
Am J Gastroenterol. 1996 Jul;91(7):1450-2.
Brown bowel syndrome is a rare condition characterized by deposition of lipofuscin in the smooth muscle cells of the gastrointestinal tract. The number of reported cases is small, but all are associated with malabsorptive states. Despite these small numbers, there is considerable evidence that vitamin E deficiency is important etiologically. We report here the case of a severely malnourished [body mass index 11.7 kg/m (2): normal range 20-25 kg/m (2)] 31-yr-old black male with a longstanding history of alcohol abuse, who was on anti-tuberculosis therapy. The patient presented with an acute abdomen and was found, at operation, to have a mid-ileal intussusception. Histological examination of the resected specimen demonstrated lipofuscin accumulation consistent with brown bowel syndrome, but no tumor. Subsequent investigations revealed no significant quantities of vitamin E in the blood and pancreatic steatorrhea. However, deficiency of other fat-soluble (vitamin A and D) and water-soluble vitamins (vitamin C and thiamine) also were detected. This report supports the association of brown bowel syndrome with vitamin E deficiency but cannot exclude the compounding effects of protein calorie malnutrition, multiple vitamin deficiencies, and chronic alcohol toxicity.
棕色肠综合征是一种罕见病症，其特征为脂褐素在胃肠道平滑肌细胞中沉积。报告的病例数量较少，但均与吸收不良状态有关。尽管病例数量不多，但有大量证据表明维生素E缺乏在病因学上具有重要意义。我们在此报告一例严重营养不良的31岁黑人男性病例[体重指数11.7 kg/m²：正常范围20 - 25 kg/m²]，有长期酗酒史，正在接受抗结核治疗。该患者出现急腹症，手术时发现回肠中段套叠。切除标本的组织学检查显示脂褐素积聚，符合棕色肠综合征，但未发现肿瘤。随后的检查发现血液中维生素E含量不高且存在胰腺性脂肪泻。然而，还检测到其他脂溶性维生素（维生素A和D）和水溶性维生素（维生素C和硫胺素）缺乏。本报告支持棕色肠综合征与维生素E缺乏之间的关联，但不能排除蛋白质热量营养不良、多种维生素缺乏和慢性酒精中毒的复合影响。
