INTESTINE Vol.19 No.2(2-1-3)


特集名 小腸の炎症
題名 各論 (1) 原因不明慢性炎症性疾患 c. 非特異性多発性小腸潰瘍症およびその他の原因不明慢性炎症性腸疾患
発刊年月 2015年 03月
著者 安川 重義 福岡大学筑紫病院消化器内科
著者 平井 郁仁 福岡大学筑紫病院病理部
著者 高津 典孝 福岡大学筑紫病院病理部
著者 矢野 豊 福岡大学筑紫病院病理部
著者 長浜 孝 福岡大学筑紫病院病理部
著者 久部 高司 福岡大学筑紫病院病理部
著者 松井 敏幸 福岡大学筑紫病院病理部
著者 池田 圭祐 福岡大学筑紫病院病理部
著者 岩下 明德 福岡大学筑紫病院病理部
【 要旨 】 クローン病やベーチェット病,単純性潰瘍を除く原因不明の慢性炎症性腸疾患として,非特異性多発性小腸潰瘍症(CNSU),また当院で経験した里吉症候群のびまん性小腸病変について述べた.非特異性多発性小腸潰瘍症の臨床像は,持続的な便潜血陽性,若年期より続く鉄欠乏性貧血,低蛋白血症を特徴とする.病変は終末回腸を除く中~下部小腸に好発し,輪状から斜走状の浅い潰瘍を認め,介在粘膜は原則的に正常である.稀少疾患であるが,典型的な経過,所見を呈し,診断にはこれを把握することが重要である.里吉症候群は進行性筋痙攣,全身脱毛,下痢を主症状とする疾患で,本症例の小腸病変はびまん性に認め,粘膜面は粗糙,大小不同の顆粒状隆起を特徴とする.本来,神経疾患と考えられてきたが,近年,その腸管病変の存在が知られつつある.
Theme Intestinal inflammation in small bowel
Title Chronic inflammatory bowel diseases of unknown etiology -- chronic nonspecific multiple ulcers of the small intestine and other (chronic inflammatory bowel disease of unknown etiology)
Author Shigeyoshi Yasukawa Department of Gastroenterolog, Fukuoka University Chikushi Hospital
Author Fumihito Hirai Department of Pathology, Fukuoka University Chikushi Hospital
Author Noritaka Takatsu Department of Pathology, Fukuoka University Chikushi Hospital
Author Yutaka Yano Department of Pathology, Fukuoka University Chikushi Hospital
Author Takashi Nagahama Department of Pathology, Fukuoka University Chikushi Hospital
Author Takashi Hisabe Department of Pathology, Fukuoka University Chikushi Hospital
Author Toshiyuki Matsui Department of Pathology, Fukuoka University Chikushi Hospital
Author Keisuke Ikeda Department of Pathology, Fukuoka University Chikushi Hospital
Author Akinori Iwashita Department of Pathology, Fukuoka University Chikushi Hospital
[ Summary ] Chronic inflammatory bowel diseases of unknown etiology, other than Crohn's disease, Behçet's disease, simple ulcers, non-specific multiple ulcers of the small intestine and diffuse small intestinal lesions associated with Satoyoshi syndrome are examined in relation to a case encountered in our hospital. The clinical presentation of non-specific multiple ulcers of the small intestine is characterized by a persistent positive result on fecal occult blood tests, as well as iron-deficiency anemia and hypoproteinemia begining at an early age. These lesions commonly occur in the middle to lower small intestine, excluding the terminal ileum and are associated with shallow ulcers of annular to oblique shape. Generally normal intervening mucosae are also present. This is a rare disease, with a characteristic course and findings. Recognition of these symptoms is important for diagnosis. Satoyoshi syndrome is primarily characterized by symptoms including progressive muscle spasms, alopecia universalis, and diarrhea. In this case, diffuse small intestinal lesions were observed, with characteristics of a rough mucosal surface and granular elevations of various sizes. Satoyoshi syndrome has traditionally been considered a neurological disease, but the presence of intestinal lesions associated with this syndrome have recently been observed.
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