Eosinophilic enteritis requiring differentiation from chronic enteropathy associated with SLCO2A1 gene:A case report  

作　　者：Kantaro Kimura Keisuke Jimbo Nobuyasu Arai Masamichi Sato Mitsuyoshi Suzuki Takahiro Kudo Tomonori Yano Toshiaki Shimizu 

机构地区：[1]Department of Pediatrics,Juntendo University Faculty of Medicine,Tokyo 113-8421,Japan [2]Department of Medicine,Jichi Medical University,Tochigi 329-0498,Japan

出　　处：《World Journal of Gastroenterology》2023年第11期1757-1764,共8页世界胃肠病学杂志（英文版）

基　　金：Supported by a Japan Society for the Promotion of Science KAKENHI Grant-in-Aid for Young Scientists,No.20K16905.

摘　　要：BACKGROUND Eosinophilic gastrointestinal disease(EGID)is a disorder characterized by infiltration of eosinophils causing mucosal damage and dysfunction of the gastrointestinal tract.The endoscopic findings of eosinophilic enteritis(EoN),an EGID variant,are nonspecific and occasionally difficult to diagnose.In contrast,chronic enteropathy associated with SLCO2A1(CEAS)is a chronic persistent small intestinal disorder characterized by endoscopic findings such as multiple oblique and circular ulcers.CASE SUMMARY We report the case of a 10-year-old boy who had suffered abdominal pain and fatigue for the preceding 6 mo.He was referred to our institute for investigation of suspected gastrointestinal bleeding because of severe anemia with hypoproteinemia and positive fecal human hemoglobin.The upper and lower gastrointestinal endoscopic findings were normal;however,double-balloon small bowel endoscopy showed multiple oblique and circular ulcers with discrete margins and mild constriction of the intestinal lumen in the ileum.The findings were highly consistent with CEAS,but urine prostaglandin metabolites were within normal limits,and no previously reported mutations in the SLCO2A1 gene were identified.Histological evaluation demonstrated moderate to severe eosinophilic infiltration localized to the small intestine suggesting a diagnosis of EoN.Clinical remission was maintained with montelukast and a partial elemental diet,but emergent surgery for bowel obstruction due to small intestinal stenosis was performed two years after the initial treatment.CONCLUSION EoN should be considered in the differential diagnosis of CEAS-like small intestinal ulcerative lesions and normal urinary prostaglandin metabolite levels.

关 键 词：Anemia Chronic enteropathy associated with SLCO2A1 Double-balloon endoscopy Eosinophilic gastrointestinal disease HYPOPROTEINEMIA Case report 

分 类 号：R574[医药卫生—消化系统]