慢性的な下痢の患者における乳球性腸炎
Serena Tseng1, Mohini Pathria2
1Pediatrics, UC Davis Health, Sacramento, California, USA.
BMJ case reports
|August 21, 2025
まとめ
マストサイト性腸炎は希少な疾患で,慢性腹が多発した刺激性腸症候群 (IBS-D) の患者で診断されました. 抗ヒスタミン剤とプレバイオティクスの治療は 症状を効果的に改善し 新しい治療法を提供しました
科学分野:
- 胃腸内科
- 免疫学
- ヒストパトロジー
背景:
- マスト細胞性腸炎は,腸内粘膜にマスト細胞の浸透が増加することを特徴とする稀な胃腸疾患である.
- 消化不全症候群と下痢 (IBS-D) は,症状が重なり合っている一般的な機能的胃腸疾患です.
- IBS- Dと乳球腸炎を区別することは,適切な患者管理に不可欠です.
研究 の 目的:
- 長期にわたるIBS-Dの疑いのある患者の乳球腸炎を報告する.
- コロノスコピーと免疫ヒストキミカル染色を含む診断アプローチを強調する.
- 抗ヒスタミン剤とプリバイオティクスを含む効果的な治療戦略を記述する.
主な方法:
- 60代の女性患者が 慢性的な下痢と排泄症で 大腸内視鏡検査を受けました
- 胃腸バイオプシを採取し,マスト細胞浸透を特定するためにCD117の免疫ヒスト化学染色を用いて分析した.
- 治療への反応は,臨床症状の改善に基づいて評価された.
主要な成果:
- 患者は全身性乳球炎を除いて,生検結果に基づいて乳球性腸炎と診断された.
- クロモリンナトリウムによる初期治療は効果的ではなかった.
- H1とH2の抗ヒスタミン剤とプリバイオティクスの組み合わせは,臨床症状の有意な改善をもたらしました.
結論:
- マスト細胞性腸炎は,耐火性IBS- Dの患者で検討されるべきであり,生検とマスト細胞の染色は主要な診断手段である.
- プレバイオティックとプロバイオティックサプリメントは このケースで示されたように マスト細胞性腸炎の有望な治療法です
- この症例は医学文献に記載されていない マスト細胞性腸炎の新たな治療法を示しています
関連する概念動画
01:17Chronic Bowel Disorders: Introduction
540
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
540
01:30Inflammatory Bowel Disease II: Crohn's Disease
382
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
382
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
321
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
321
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
419
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
419
01:25Assessment of the Rectum and Anus
400
Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
400
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
245
Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
245