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要旨 患者は60歳代,女性.2008年6月頃から1日10行前後の水様性下痢と体重減少を認めていた.2009年2月,原因精査目的で当院へ紹介され,消化管検査を施行したところ,上部小腸を主体としたびまん性の絨毛萎縮がみられ,病理組織学的にもceliac病に矛盾しない所見であった.診断に際しては,特に拡大内視鏡による微細観察が有用であった.グルテン除去食(gluten free diet)開始後,下痢は改善し,celiac病の臨床経過として矛盾しないものであった.その後の経過でperipheral T-cell lymphoma(not otherwise specified)を発症した.今回,筆者らは,本邦ではまれであるceliac病の,NBI併用拡大内視鏡観察を含めた典型的内視鏡所見,X線所見および病理組織学的所見を確認しえたので,文献的考察を加え報告する.
We present a case of 60-year-old woman. She had been experiencing watery diarrhea, 10 times a day and weight loss since June 2008. She was referred to our hospital for a gastro-intestinal's examination in Feburary 2009. The findings indicated pervaded villous atrophy, mainly in the upper portion of the small intestine. Pathological examination findings were indicative of celiac disease. We confirmed this diagnosis by using magnifying endoscopy. Diarrhea improved after gluten-free diet which was recommended in clinical course in cases of celiac disease. Thereafter, she developed peripheral T-cell lymphoma(not otherwise specified).
We reported a rare case of celiac disease with Japanese patient, who confirmed the presence of this disease with typical magnifying endoscopy, pathological findings and x-rays scans.
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