食道潰瘍を契機として発見されたBehçet病の1例

Behçet's Disease with Esophageal Ulcers, Report of a Case

要旨　食道潰瘍を契機に発見されたBehçet病の1例を経験した．患者は56歳の女性．1986年ごろから再発性の口腔内アフタと陰部潰瘍を繰り返していた．1991年10月15日ごろから，思い当たる誘因もなく胸骨裏痛が出現したため来院した．上部消化管内視鏡検査で中部食道および食道胃接合部粘膜に3個の円形から楕円形の潰瘍が認められた．大腸内視鏡検査では回盲部にもアフタ様病変が発見され，不全型の腸管Behçet病と診断した。食道潰瘍に対して抗潰瘍薬を投与したが効果はなく，炎症反応も上昇したが，colchicine 1mg/dayの投与により炎症反応は改善し，食道潰瘍も治癒した．

　A 56-year-old woman visited to our hospital complaining of retrosternal pain. During the preceeding six years, she had experienced recurrences of oral and genital ulcers.

　Laboratory examinations disclosed an accelerated ESR, positive C-reactive protein and leukocytosis.

　Upper gastrointestinal (GI) endoscopy revealed three oval-shaped, shallow ulcers in the middle esophagus and E-G junction. Investigation of the lower GI tract revealed aphtoid ulcers in the terminal ileum and the diagnosis of Behget's disease was confirmed. Esophageal ulcers were considered as an esophageal involvement of Behçet's disease. Esophageal lesions were refractory to treatment with H₂ receptor antagonist. Instead, oral administration of colchicine (1mg/day) was effective.

　We reported a case of Behçet's disease with esophageal ulcers in which colchicine was effective.