Asunto(s)
Colitis Colagenosa , Colitis , Humanos , Colitis Colagenosa/diagnóstico por imagen , Colon , EndoscopíaAsunto(s)
Colitis Colagenosa/diagnóstico por imagen , Colitis Colagenosa/patología , Mucosa Intestinal/patología , Anciano , Enfermedad Crónica , Colitis Colagenosa/inducido químicamente , Colon/diagnóstico por imagen , Colon/patología , Diarrea/tratamiento farmacológico , Endoscopía del Sistema Digestivo/métodos , Humanos , Lansoprazol/efectos adversos , Masculino , Inhibidores de la Bomba de Protones/efectos adversosAsunto(s)
Colitis Colagenosa/complicaciones , Enfermedad de Moyamoya/etiología , Accidente Cerebrovascular/complicaciones , Colitis Colagenosa/diagnóstico por imagen , Angiografía por Tomografía Computarizada , Femenino , Humanos , Persona de Mediana Edad , Enfermedad de Moyamoya/diagnóstico por imagen , Accidente Cerebrovascular/diagnóstico por imagen , Accidente Cerebrovascular/tratamiento farmacológico , Activador de Tejido Plasminógeno/uso terapéutico , Tomógrafos Computarizados por Rayos XRESUMEN
We herein describe a 69-year-old man suffering from chronic diarrhea caused by lansoprazole (LPZ)-induced collagenous colitis (CC) accompanied with protein-losing enteropathy (PLE), diagnosed by increased fecal alpha-1 antitrypsin clearance and the findings of leakage from the descending colon to the sigmoid colon on scintigraphy. MR enterocolonography (MREC) was also performed for differentiating digestive diseases, and inflamed findings were observed around the same portion as those on scintigraphy, suggesting that this region was responsible for protein loss in this case. The MREC findings improved after the cessation of LPZ, and hypoalbuminemia also improved simultaneously. This case suggests that MREC may be a new and useful diagnostic tool for CC with PLE.
Asunto(s)
Colitis Colagenosa/inducido químicamente , Colitis Colagenosa/terapia , Diarrea/inducido químicamente , Lansoprazol/efectos adversos , Enteropatías Perdedoras de Proteínas/diagnóstico por imagen , Enteropatías Perdedoras de Proteínas/terapia , Anciano , Colitis Colagenosa/diagnóstico por imagen , Diarrea/terapia , Humanos , Imagen por Resonancia Magnética , Masculino , Enteropatías Perdedoras de Proteínas/etiología , Enfermedades Raras/diagnóstico , Enfermedades Raras/terapia , Resultado del TratamientoRESUMEN
Collagenous colitis is a clinicopathologic syndrome characterized by chronic watery diarrhea and unique histopathologic features. Spontaneous colonic perforation in the setting of collagenous colitis is a highly unusual complication, with only three cases reported in the literature to date. We present a fourth case and propose a potential pathologic mechanism for acute colonic perforation in this patient population.
Asunto(s)
Colitis Colagenosa/complicaciones , Perforación Intestinal/etiología , Perforación Espontánea/etiología , Colitis Colagenosa/diagnóstico por imagen , Colitis Colagenosa/patología , Enfermedades del Colon/diagnóstico por imagen , Enfermedades del Colon/etiología , Enfermedades del Colon/patología , Femenino , Humanos , Perforación Intestinal/diagnóstico por imagen , Perforación Intestinal/patología , Persona de Mediana Edad , Perforación Espontánea/diagnóstico por imagen , Perforación Espontánea/patología , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: Collagenous colitis (CC) is a chronic inflammatory bowel disease that affects the colon. However, some patients with CC present with accompanying pathologic small-bowel manifestations such as coeliac disease, defects in bile acid absorption and histopathologic changes in small-intestinal biopsies, indicating that CC is a pan-intestinal disease. In small-intestinal disease, the intestinal barrier function may be impaired, and the permeability of the small intestine altered. The purpose of this research was to study small-bowel function in patients with CC as expressed by intestinal permeability. MATERIAL AND METHODS: Ten patients with CC and chronic diarrhoea participated in the study. Coeliac disease was excluded by small-bowel biopsy and/or serology. Intestinal permeability was assessed as urinary excretion (ratios) 2, 4 and 6 h after ingestion of 14C-labelled mannitol (14C-mannitol) and 99mTc-labelled diethylenetriamine-pentaacetic acid (99mTc-DTPA). Data were compared with the results from healthy controls. RESULTS: No difference was found between groups in urinary excretion of 14C-mannitol and 99mTc-DTPA after 2, 4 or 6 h, respectively. Likewise, no significant differences in the 99mTc-DTPA/14C-mannitol ratios between patients and controls were detected after 2 h: 0.030 (0.008-0.130) versus 0.020 (0.007-0.030), p = 0.19, after 4 h: 0.040 (0.009-0.180) versus 0.020 (0.008-0.040), p = 0.14 or after 6 h: 0.040 (0.012-0.180) versus 0.020 (0.010-0.040), p = 0.17. CONCLUSIONS: No alterations in intestinal permeability in patients with CC could be demonstrated. Impairment of the integrity of the mucosa of the small bowel and the presence of a general dysfunction of the small intestine in patients with CC seem unlikely.