Developed and Relapsed Simple Ulcer by Interferon Therapy, Report of a Case Masaki Taruishi 1 , Yusuke Saitoh 1 , Motoya Tominaga 1 , Kenichiro Ozawa 1 , Ryuji Sugiyama 1 , Satoshi Suzuki 1 , Kazumasa Nakamura 1 , Ryuji Sukegawa 1 , Atsushi Chiba 1 , Akio Takada 2 1Digestive Disease Center, Asahikawa City Hospital, Asahikawa, Japan 2Department of Pathology, Asahikawa City Hospital, Asahikawa, Japan Keyword: 単純性潰瘍 , インターフェロン , NSAID pp.1081-1089
Published Date 2011/6/25
DOI https://doi.org/10.11477/mf.1403102281
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 There have been cases of ulcerative colitis, ischemic colitis, eosinophilic enteritis, abscess formation in the ileo-cecal region and multiple ulcers reported as intestinal diseases complicated by interferon therapy and the causes were estimated by immuno-regulation effect and occlusion of microvessels. We report a case of simple ulcer treated by interferon therapy, later relapsed.

 A 63-year-old. patient was admitted to our unit presenting by right lower abdominal pain, fever and diarrhea. He had presented the same symptoms 7 months before and at that time, he was administered interferonαfor C type chronic hepatitis. CT scan showed marked wall thickness and an ulcer in the terminal ileum. Colonoscopy revealed a huge round-shaped deeply undermining ulcer with surrounding redness and edematous mucosa, and multiple oval-shaped ulcers, 5-6mm in size, in the terminal ileum. There were no abnormal colonoscopic findings in the colon. Biopsy specimens taken from the ulcer margin and bottom part revealed non-specific inflammation without epitheloid granuloma, inclusion body and apoptotic body, findings which are consistent with simple ulcer. After being treated by 5-ASA(aminosalicylic acid)and TEN(total enteral nutrition), the ulcers healed and the patient was discharged.

 Repeated interferron therapy with interferonβand diclofenac were carried out 3 months after discharge and CRP value rose 3 days after, and right lower abdominal pain was presented 5 days after therapy had started. CT scan showed the same findings of wall thickness in the terminal ileum. Colonoscopy revealed the same undermining ulcer in the terminal ileum as before and this time, oval shaped ulcers or circularly arranged shallow ulcers on the haustra folds in the right colon. Biopsy specimens showed the same non-specific inflammation as before. This time, we diagnosed the lesion as relapsed simple ulcer due to interferon therapy and concommitant NSAID(nonsteroidal anti-inflammatory drug)ulcer by dicrofenac. Symptoms and the findings of the patient showed recorery again with the suspension of interferon therapy and enteral nutrition. The patient was followed up in the outpatient and showed a good course of recovery.

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