長期間緩解を維持しているCrohn病の2例―経過についての考察

Crohn's Disease Exhibiting a Favorable Clinical Course, Report of Two Cases

要旨　初回診断から10年以上にわたって，緩解を維持しているCrohn病の2例を呈示した．初回診断時，〔症例1〕は縦走潰瘍と狭窄を認める小腸大腸型，〔症例2〕は敷石像を主体とする小腸型Crohn病で，ともに中心静脈栄養で緩解導入後，半消化態栄養剤による栄養療法を経て11年および10年間無治療のまま緩解を維持している．呈示症例をさかのぼ及的に検討すると，初回診断時のX線所見のみから長期予後を予測することが必ずしも容易でないことが示唆された．

　The long-term clinical course of Crohn's disease has been characterized by frequent relapse and development of intestinal complications. We reported two cases of the disease which remained in remission for more than ten years without any specific treatment. In a case of ileocolitis type, inflammatory polyposis of the colon exhibited scarred ulcers during a 19-year period of observation whereas stenosis of the terminal ileum persisted. Initial cobblestone appearance of the other case of ileitis type exhibited eccentric deformities for 10 years. Our cases suggest that there may be a subtype of Crohn's disease characterized by a rather favorable course which can not be predicted by clinical manifestations at the initial diagnosis.