長期経過中に腎アミロイドーシスを合併したCrohn病の1例

Crohn's Disease Associated with Renal Amyloidosis, Report of a Case

要旨　患者は29歳の女性．1985年（14歳時）に下痢が出現．1986年に発熱，関節炎が出現し，大腸型のCrohn病と診断された．その後，steroid，salazosulfapyridineなどで治療されていたが，入退院を繰り返した．1993年5月には上行結腸の狭窄のため結腸唖全摘術を施行した．その後，salazosulfapyridineで治療されていたが，1997年2月には発熱，貧血，低蛋白血症で入院．腸管狭窄（回腸S状結腸吻合部およびその口側の回腸）のため回腸，S状結腸の部分切除術を施行した．1998年8月には貧血，低蛋白血症で入院．大量の蛋白尿を認め，ネフローゼ症候群を呈していた．腎生検の結果，アミロイド（AA型）の沈着を認めた．

　We report a case of a 29-year-old female with Crohn's disease associated with renal amyloidosis. In 1985, at the age of 14, she developed diarrhea. In 1986, she developed fever and arthralgia. A diagnosis of Crohn's disease was made by endoscopic and radiographic examinations. Thereafter, she received corticosteroids and salazosulfapyridine. However, hospitalization was required several times. In May 1993, subtotal colectomy and ileocecal resection with ileosigmoid anastomosis was performed because of severe stenosis of the ascending colon. In Feb. 1997, she was admitted because of fever, anemia, and hypoproteinemia. Partial resection of the ileum and the anastomosis was performed because of the stenosis. In Aug. 1998, she was admitted because of anemia and hypoproteinemia. Massive proteinuria was observed. Renal biopsy demonstrated amyloid deposition.