Murakami K, Fujioka T, Nishizono A, Nagai J, Tokieda M, Kodama R, Kubota T, Nasu M
Second Department of Internal Medicine, Oita Medical University, Japan.
J Gastroenterol. 1996 Nov;31 Suppl 9:77-82.
A relationship between allergic diseases and Helicobacter pylori infection has recently been noted. We report a case of atopic dermatitis and H. pylori infection in a 14-year-old girl. She had had widespread diffuse skin erythema with erosions and pigmentation since the age of 3 years. Endoscopically, there was chronic antral gastritis with H. pylori infection and histological eosinophilic infiltration. A high titer of H. pylori-specific IgG was present in serum. She was treated with a proton pump inhibitor (lansoprazole 60 mg), an antibiotic (clarithromycin 800 mg), and plaunotol (a mucosal protective agent, 480 mg) for 2 weeks to eliminate the infection. After 10 days of treatment, erythema and itching were more widespread and vesicle formation was seen on the foot. Generalized skin lesions abated a few days later. After eradication of the bacterium by the treatment, eosinophils decreased from 38.8% to 19.0%, and the clinical signs of atopic dermatitis almost disappeared. Serum gastrin level and the pepsinogen I/II ratio were normalized and histological findings of gastric mucosa showed improvement. H. pylori-specific IgE antibody, analyzed by the Western blot method, gradually decreased with the eradication treatment.
最近人们注意到过敏性疾病与幽门螺杆菌感染之间存在关联。我们报告一例14岁女孩的特应性皮炎合并幽门螺杆菌感染病例。自3岁起，她就出现广泛弥漫性皮肤红斑，伴有糜烂和色素沉着。内镜检查显示存在慢性胃窦炎合并幽门螺杆菌感染以及组织学嗜酸性粒细胞浸润。血清中存在高滴度的幽门螺杆菌特异性IgG。她接受了质子泵抑制剂（兰索拉唑60毫克）、抗生素（克拉霉素800毫克）和普劳诺托（一种黏膜保护剂，480毫克）治疗2周以消除感染。治疗10天后，红斑和瘙痒更加广泛，足部出现水疱形成。几天后全身皮肤病变减轻。通过治疗根除细菌后，嗜酸性粒细胞从38.8%降至19.0%，特应性皮炎的临床症状几乎消失。血清胃泌素水平和胃蛋白酶原I/II比值恢复正常，胃黏膜的组织学检查结果显示有所改善。通过蛋白质印迹法分析的幽门螺杆菌特异性IgE抗体随着根除治疗逐渐下降。
