ステロイド内服とエカベトナトリウム注腸が奏功したcap polyposisの1例

A Successful Treatment for Cap Polyposis by Oral Steroid Administration and Ecabet Sodium Enema, Report of a Case

要旨　症例は41歳，女性．2年前より血性下痢を認めSalazopyrin等の治療を受けるも改善なし．2000年1月より下腹部痛と粘血便を認め4月当科入院．血液検査で総蛋白3.7g/dlと著明な低蛋白血症を認めた．注腸および内視鏡検査で直腸から横行結腸に径5～20mmで表面にびらん・発赤を伴うⅠs～Ⅰsp型ポリープの多発を認め，病理学的には上皮の過形成と管状腺管の拡張をみてcap polyposisと診断した．ステロイドの内服とエカベトナトリウム注腸により症状の消失と血清蛋白の増加に加え内視鏡的にもポリープの縮小・消失を得た．cap polyposisの治療法は確立されておらず今後の症例の集積が望まれる．

　A 41-year-old woman was admitted to our hospital with the complaint of lower abdominal pain and bloody mucous stool. She had a prior diagnosis of ulcerative colitis, which had been unsuccessfully treated with salazosulphapyridine two years before admission to our hospital. Clinical examination showed severe hypoproteinemia and mild anemia. Barium enema and colonoscopy revealed multiple variously formed polyps with redness and erosion from the rectum to the transverse colon. Biopsy specimens showed superficial erosion with elongated hyperplastic glands. These findings suggested cap polyposis. The patient responded to the combination therapy of oral steroid administration and ecabet sodium enema. She achieved clinical and endoscopic remission after 4 weeks.