カプセル内視鏡，バルーン内視鏡で小腸炎を観察しえた好酸球性胃腸炎の1例

Eosinophilic Gastroenteritis Observed Using Single-balloon Enteroscopy and Capsule Endoscopy, Report of a Case

要旨　患者は30歳代，男性．主訴，腹痛．25歳時に，腹痛を認めたが原因不明であった．渡航先で腹痛を自覚し，現地の病院を受診した．抗菌薬の投与を受けたが症状は改善せず，紹介され受診し，入院となる．血液検査で好酸球増多，IgE高値，CTで小腸の全周性肥厚，浮腫，腹水を認めた．経口から行ったシングルバルーン小腸内視鏡検査では，十二指腸，空腸に，浮腫，発赤，びらんが認められ，病理組織学的所見は，好酸球の著明な浸潤が認められた．プレドニゾロン投与を開始し，症状は改善，治療効果判定のため行ったカプセル内視鏡検査では，上部空腸に軽度の発赤，浮腫を認めた．その後，プレドニゾロンを漸減中止としたが，症状の再発は認められなかった．

　A 30-year-old man with abdominal pain was referred to our hospital to investigate indeterminate enteritis. His laboratory tests showed marked eosinophilia and a high level of IgE. Computed tomography showed circumferential thickening of the entire small intestine and ascites. Peroral single-balloon enteroscopy revealed mucosal edema, redness, and erosion in the duodenum and the upper jejunum. Biopsies of the duodenum and jejunum showed marked infiltration by eosinophils. Administration of intravenous prednisolone improved his symptoms. CE（capsule endoscopy）was performed to assess the therapeutic effects. CE showed a mildly edematous mucosa and redness in the upper jejunum. After that, oral prednisolone was tapered off and discontinued, and there was no recurrence of his symptoms.