利图西马布治疗后与腹和结肠病变相关的马拉科普拉基亚
Yaqoub Alshatti1, Meshaan Alenezi1
1Gastroenterology Department, Adan Hospital Kuwait, Hadiya, Kuwait.
European journal of case reports in internal medicine
|January 10, 2025
概括
罕见的马拉科普拉基亚,一种模仿炎症性肠病的疾病,可能发生在Rituximab治疗后免疫抑制患者. 通过组织病理学及时诊断和抗生素治疗可以导致解决.
科学领域:
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
- 病理学 病理学 病理学
背景情况:
- 马拉科普拉基亚是一种罕见的颗粒状细胞性疾病,由缺陷的菌体消化引起.
- 它可以模仿炎症性肠病 (IBD) 或恶性瘤,特别是在免疫抑制个体.
- 用于治疗各种疾病的利图西马布治疗可以增加机会性感染和异常呈现的风险.
研究的目的:
- 报告一个以结肠病变呈现的马拉科普拉基亚病例,该病例发生在一个免疫抑制患者的里图西马布治疗后.
- 突出诊断挑战,并强调在这种患者群体中对胃肠道症状的差异诊断中考虑马拉科普拉基亚的重要性.
主要方法:
- 一个62岁的男性患有IgG4相关的轨道病变和脏综合征的病例报告.
- 临床表现包括在rituximab治疗后持续的腹和结肠病变.
- 诊断得到了结肠镜检查结果和显示迈凯利斯-古特曼体的活检组织病理学分析的证实.
主要成果:
- 结肠镜检查显示有IBD特征的胰腺炎,但组织学证实了 malakoplakia.
- 患者对西普罗夫洛克萨辛治疗和停止使用类固醇反应良好.
- 在随访期间观察到完整的症状消失和显著的组织学改善.
结论:
- 在表现为异型胃肠病变的免疫抑制患者中,应考虑马拉科普拉基亚,以避免误诊为IBD.
- 迈凯利斯-古特曼体的组织病理学鉴定对于准确的诊断至关重要.
- 停止免疫抑制疗法和适当的抗生素治疗是成功管理的关键.
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