十二指腸と回盲弁に特徴的な内視鏡所見を呈した消化管非結核性抗酸菌症の1例

Endoscopic Appearance of Gastrointestinal Nontuberculosis Mycobacteria, Report of a Case

要旨●水様便，体重減少の精査の内視鏡にて十二指腸，回盲弁に白色調の病変を認めた．病変部の生検による病理組織学的評価および培養検査からMycobacterium avium complexによる消化管病変と診断された．消化管非結核性抗酸菌症は，まれであるが，抗HIV薬投与前，CD4の低下したHIV感染者の内視鏡を行う際は念頭に置くべき疾患のひとつである．

　Due to symptoms of watery diarrhea and weight loss, upper and lower gastrointestinal endoscopy were performed, which revealed whitish elevated lesions in the duodenum and at the ileocecal valve. Histopathology and culture from biopsy specimens showed Mycobacterium avium complex-related gastrointestinal lesions. Although gastrointestinal non-tuberculosis mycobacteria is rare in the gastrointestinal tract, clinicians should keep this in mind during endoscopy, particularly in HIV-infected patients with prior-　antiretroviral therapy or low CD4 counts.