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要旨●[症例1]患者は20歳代,男性.1歳時より難治性鉄欠乏性貧血,低蛋白血症を認めていた.X線造影検査で中部小腸に非対称性の変形・狭窄が多発しており,小腸内視鏡検査で狭小化を伴う浅い開放性潰瘍が確認された.SLCO2A1遺伝子変異を有しており,非特異性多発性小腸潰瘍症と診断した.[症例2]患者は60歳代,男性.15歳頃から貧血を指摘され,小腸切除術を施行されている.X線造影検査および内視鏡検査で中部小腸に短い狭小化と全周性の帯状の開放性潰瘍を認め,SLCO2A1遺伝子変異が確認された.2症例とも皮膚病変として,ばち指と前額部の皮膚肥厚所見を有しており,肥厚性皮膚骨膜症の徴候を伴った非特異性多発性小腸潰瘍症と診断した.
[Case 1]A 26-year-old man had a long history of refractory iron deficiency anemia and hypoproteinemia. Small-bowel radiography showed multiple bilateral or eccentric deformities and stenoses in the ileum. Double-balloon enteroscopy demonstrated shallow and eccentric ulcers with stenosis in the ileum. We diagnosed chronic enteropathy associated with the SLCO2A1 gene(CEAS)based on genetic analysis.
[Case 2]A 63-year-old man had a long history of anemia and had undergone ileal resection. Small-bowel radiography and enteroscopy showed multiple circumferential ulcers with short stenoses in the ileum. Genetic analysis for SLCO2A1 revealed a homozygous nonsynonymous mutation(c.664G>A), and the diagnosis was CEAS.
Both patients had digital clubbing and pachydermia of the forehead as cutaneous lesions of CEAS. Thus, we should remember that CEAS sometimes presents cutaneous lesions.
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