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

特集名 小腸の炎症
題名 各論 (1) 原因不明慢性炎症性疾患 b. 腸管ベーチェット病・単純性潰瘍
発刊年月 2015年 03月
著者 横山 薫 北里大学医学部消化器内科学
著者 小林 清典 北里大学医学部新世紀医療開発センター
【 要旨 】 腸管ベーチェット病(腸管Behçet's disease; 腸管BD)と単純性潰瘍(simple ulcer;SU)は回盲部に大形の下掘れ潰瘍を認めるが,内視鏡所見のみでは鑑別できない.腸管病変以外の病変の有無により診断されるが,分類に苦慮する症例も少なくない.最近カプセル内視鏡やバルーン内視鏡が普及し,回盲部以外の小腸病変が少なくないことが報告されている.また,腸管BDに対する抗TNF-α抗体製剤(アダリムマブ)の使用が保険承認され,今後の臨床経過や長期経過の変遷が注目される.
Theme Intestinal inflammation in small bowel
Title Intestinal Behçet's disease and simple ulcers
Author Kaoru Yokoyama Department of Gastroenterology, Kitasato University School of Medicine
Author Kiyonori Kobayashi Research and Development Center for New Medical Frontiers, Kitasato University School of Medicine
[ Summary ] Intestinal Behçet's disease and simple ulcers are associated with large undermining ulcers in the ileocecum, but differential diagnosis is not feasible on the basis of endoscopic findings alone. Diagnosis is based on the presence or absence of lesions other than those arising in the intestine, but some cases are difficult to classify. With the recent increased use of capsule endoscopy and balloon endoscopy, small-bowel lesions other than those in the ileocecum have been reported in a considerable number of cases. An anti-TNF-alpha antibody preparation (adalimumab) has been approved for the treatment of intestinal Behçet's disease under National Health Insurance, and changes in the future clinical course and long-term course are expected to receive considerable attention.