Atypical Clinical Presentation of Crohn's Disease with Superior Mesenteric Vein Obstruction and Protein-losing Enteropathy

被引：6

作者：

Ito, Suguru ^{[1
]}

Higashiyama, Masaaki ^{[1
]}

Horiuchi, Kazuki ^{[1
]}

Mizoguchi, Akinori ^{[1
]}

Soga, Shigeyoshi ^{[2
]}

Tanemoto, Rina ^{[3
]}

Nishii, Shin ^{[1
]}

Terada, Hisato ^{[1
]}

Wada, Akinori ^{[1
]}

Sugihara, Nao ^{[1
]}

Hanawa, Yoshinori ^{[1
]}

Furuhashi, Hirotaka ^{[1
]}

Takajo, Takeshi ^{[1
]}

Shirakabe, Kazuhiko ^{[1
]}

Watanabe, Chikako ^{[1
]}

Komoto, Shunsuke ^{[1
]}

Tomita, Kengo ^{[1
]}

Nagao, Shigeaki ^{[1
]}

Shinozaki, Masami ^{[4
]}

Nakagawa, Akihiko ^{[4
]}

Kubota, Michio ^{[4
]}

Miyagishima, Daisuke ^{[4
]}

Gotoh, Nobuaki ^{[4
]}

Miura, Soichiro ^{[1
]}

Ueno, Hideki ^{[5
]}

Hokari, Ryota ^{[1
]}

机构：

[1] Natl Def Med Coll, Dept Internal Med, Tokorozawa, Saitama, Japan

[2] Natl Def Med Coll, Dept Radiol, Tokorozawa, Saitama, Japan

[3] Self Def Forces Cent Hosp, Dept Internal Med, Tokyo, Japan

[4] Numazu City Hosp, Dept Gastroenterol, Numazu, Japan

[5] Natl Def Med Coll, Dept Surg, Tokorozawa, Saitama, Japan

来源：

INTERNAL MEDICINE | 2019年 / 58卷 / 03期

关键词：

Crohn's disease (CD); mesenteric vein thrombosis; protein-losing enteropathy (PLE); INFLAMMATORY-BOWEL-DISEASE; VENOUS THROMBOEMBOLISM; THROMBOSIS; PLATELETS; RISK;

D O I：

10.2169/internalmedicine.1192-18

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We herein report a 44-year-old man suffering from systemic edema due to protein-losing enteropathy (PLE) with superior mesenteric vein (SMV) obstruction and development of collateral veins, which subsequently proved to be a chronic result of thrombosis and a complication of Crohn's disease (CD). PLE was supposedly induced by both intestinal erosion and thrombosis-related lymphangiectasia, which was histologically proven in his surgically-resected ileal stenosis. Elemental diet and anti-TNF alpha agent improved his hypoalbuminemia after surgery. The rarity of the simultaneous coexistence of SMV obstruction and PLE and the precedence of these complications over typical abdominal symptoms of CD made the clinical course complex.

引用

页码：369 / 374

页数：6

共 27 条

[1] Elevated circulating platelet-derived microparticles in patients with active inflammatory bowel disease [J].

Andoh, A ;

Tsujikawa, T ;

Hata, K ;

Araki, Y ;

Kitoh, K ;

Sasaki, M ;

Yoshida, T ;

Fujiyama, Y .

AMERICAN JOURNAL OF GASTROENTEROLOGY, 2005, 100 (09) :2042-2048

[2] Thrombosis in inflammatory bowel disease: Are we tailoring prophylaxis to those most at risk? [J].

Bryant, Robert V. ;

Jairath, Vipul ;

Curry, Nicola ;

Travis, Simon P. L. .

JOURNAL OF CROHNS & COLITIS, 2014, 8 (02) :166-171

[3]

Carty E, 2000, ALIMENT PHARM THERAP, V14, P1169

[4]

Cobalamin CW, 2008, J CLIN GASTROENTEROL, V42, P481

[5] TNF-α blockade down-regulates the CD40/CD40L pathway in the mucosal microcirculation:: A novel anti-inflammatory mechanism of infliximab in Crohn's disease [J].

Danese, S ;

Sans, M ;

Scaldaferri, F ;

Sgambato, A ;

Rutella, S ;

Cittadini, A ;

Piqué, JM ;

Panes, J ;

Katz, JA ;

Gasbarrini, A ;

Fiocchi, C .

JOURNAL OF IMMUNOLOGY, 2006, 176 (04) :2617-2624

[6] Homocysteine triggers mucosal microvascular activation in inflammatory bowel disease [J].

Danese, S ;

Sgambato, A ;

Papa, A ;

Scaldaferri, F ;

Pola, R ;

Sans, M ;

Lovecchio, M ;

Gasbarrini, G ;

Cittadini, A ;

Gasbarrini, A .

AMERICAN JOURNAL OF GASTROENTEROLOGY, 2005, 100 (04) :886-895

[7] Inflammatory bowel disease: the role of environmental factors [J].

Danese, S ;

Sans, M ;

Fiocchi, C .

AUTOIMMUNITY REVIEWS, 2004, 3 (05) :394-400

[8] Activated platelets are the source of elevated levels of soluble CD40 ligand in the circulation of inflammatory bowel disease patients [J].

Danese, S ;

Katz, JA ;

Saibeni, S ;

Papa, A ;

Gasbarrini, A ;

Vecchi, M ;

Fiocchi, C .

GUT, 2003, 52 (10) :1435-1441

[9] Inflammation and coagulation in inflammatory bowel disease: The clot thickens [J].

Danese, Silvio ;

Papa, Alfredo ;

Saibeni, Simone ;

Repici, Alessandro ;

Malesci, Alberto ;

Vecchi, Maurizio .

AMERICAN JOURNAL OF GASTROENTEROLOGY, 2007, 102 (01) :174-186

[10] Venous thromboembolism during active disease and remission in inflammatory bowel disease: a cohort study [J].

Grainge, Matthew J. ;

West, Joe ;

Card, Timothy R. .

LANCET, 2010, 375 (9715) :657-663

← 1 2 3 →