Crohn病の経過観察中にSLEの合併がみられた1例

Crohn's Disease Complicated with SLE, Report of a Case

要旨　患者は27歳，女性．他医で1983年に診断された小腸大腸型のCrohn病患者である．経過観察中に回腸およびS状結腸に潰瘍を認め，また，回腸直腸瘻，肛門部に盲瘻孔を認めた．典型的な縦走潰瘍，非乾酪性肉芽腫はみられないものの当科においてもCrohn病と診断された．1989年5月，顔面の蝶形紅斑，手指背面の円板紅斑，関節痛，発熱を訴え入院となった．免疫学的検査ではLE test，DNA test陽性，抗核抗体は320倍陽性でspeckled-diffuse型混在であった．血清補体価はCH₅₀ 20.9U/ml，C_3C 35mg/dl，C₄ 9.1mg/dlと低下していた．ステロイドパルス療法が行われ，後療法としてpredniso-lone 30mgの投与が行われ，解熱，関節痛の消失，皮膚の紅斑の消失，白血球，補体価の上昇が認められた．

　A 27-year-old female was diagnosed, in 1983, as having Crohn's disease. The Crohn's ulcers were found in the ileum and the sigmoid colon. Fistulas were shown in the ileo-rectum and anus. Arthralgia and skin lesions (butterfly-like erythema in the face, discoid erythema in two fingers) appeared and the patient felt feverish in May, 1989. LE test, DNA test and ANA test (speckled-diffuse type) were positive. Complements decreased. For these reasons, patient was diagnosed as having Crohn's disease complicated with SLE. Steroid was administered for treatment of SLE.

　Six cases similar to this one have been reported in world medical literature.