胃，小腸，大腸に多発潰瘍を認めたChurg-Strauss症候群（アレルギー性肉芽腫性血管炎）の1例

Churg-Strauss Syndrome with Multiple Ulcers of the Gastrointestinal Tract, Report of a Case

要旨　患者は43歳，男性．気管支喘息初発6か月後から腹痛，下痢を主訴に当院へ入院した．入院時から，発熱と下腿の紫斑性皮疹がみられた．消化管内視鏡検査で胃，十二指腸，大腸に浅い不整形の潰瘍が多発していた．血液検査では，著明な好酸球増加とIgE高値，RA陽性，血沈亢進を認め，消化管および皮膚生検で，好酸球浸潤を伴う肉芽腫様血管炎の所見を認め，Churg-Strauss症候群と診断した．IVHとステロイド治療によって，諸症状と多発潰瘍は速やかに消失し，好酸球数とIgE値は正常化した．広範な消化管病変を来したChurg-Strauss症候群は文献的にもまれであり報告した．

　A 43-year-old man, who had been diagnosed as having bronchial asthma six months prior to admission, developed a fever, abdominal pain, diarrhea and skin eruptions. The laboratory data showed marked eosinophilia and elevation of the serum IgE. Endoscopic examination showed multiple ulcers in the stomach, duodenum and colon. The biopsy specimens taken from the skin and Gastrointestinal (GI) tract showed angitis accompanied by proliferated endothelial cells and an infiltrate of eosinophils. Based on these clinical and histological findings, this case was diagnosed as ChurgStrauss syndrome. By administration of steroid, the multiple ulcers of GI tract and purpuric eruptions disappeared, and the number of eosinophil and serum concentration of IgE decreased to normal level. It is necessary to perform the biopsy from the affected area quickly in order to make a diagnosis of the angitis, and the administration of steroid is effective for Churg-Strauss syndrome.