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Japanese

Collagenous Sprue : Serial Observation by Capsule and Double Balloon Endoscopy, Report of a Case Naoko Tsubouchi 1 , Masatsugu Numata 1 , Kanae Oono 1 , Akihito Tanaka 1 , Hiroki Taguchi 1 , Junichi Nakazawa 1 , Shuji Kanmura 1 , Hiroshi Fujita 1 , Keita Funakawa 1 , Hirofumi Uto 1 , Akio Ido 1 , Mitsuharu Nomoto 2 , Hirohito Tsubouchi 3 1Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan 2Department of Clinical Pathology, Kagoshima Medical Center, Kagoshima, Japan 3Kagoshima City Hospital, Kagoshima, Japan Keyword: 吸収不良症候群 , collagenous sprue , collagen band , 小腸内視鏡検査 , prednisolone pp.1355-1361
Published Date 2014/8/25
DOI https://doi.org/10.11477/mf.1403114254
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 A 75-year-old woman was admitted to our hospital because of watery diarrhea lasting several months and anasarca. On admission, capsule endoscopy and DBE(double-balloon endoscopy)showed a loss of villi associated with multiple ulcers throughout most of the jejunum and ileum. Histological examination of the ileum showed a loss of villi and a subepithelial collagen band of 38~42μm width. Because endoscopic and histological findings indicated collagenous sprue, TPN(total parenteral nutrition)was started. The frequency of diarrhea decreased, and serum levels of C-reactive protein returned to normal, but after 3weeks of TPN, DBE and histopathological examination showed no regeneration of villi but persistence of the collagen band despite some improvement in the ulcerative lesions. Thereafter, oral prednisolone(0.5mg/kg/day)was initiated. Intensive antibiotic therapy for sepsis and Clostridium difficile colitis as well as a reduction in the prednisolone dose was undertaken. Imaging and histological examination after resolution of the infection showed regeneration of villi and disappearance of the collagen band. This is a rare case of collagenous sprue with changes observed in endoscopic findings in the small bowel during treatment.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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