アフタのみから成るCrohn病の長期経過

Long-term Course of Crohn's Disease Consisting Solely of Aphthoid Lesions

要旨　アフタのみから成るCrohn病の長期経過例を検討し，以下の成績を得た．①3年以上経過を追えたアフタのみから成るCrohn病16例中9例（56％）が進展し典型例となり，7例（44％）が不変もしくは改善した．②初診時CRP値は，進展群で高い傾向があったが有意差はなかった．③初発症状として，進展群では腹痛の頻度が低い傾向にあった．④肛門病変は進展群全例に認め，不変・改善群より有意に多かった．⑤進展例での診断時から典型病変出現までの期間は平均29.7か月であった．また進展病変は回腸もしくは盲腸・結腸にのみ認め，縦走潰瘍を形成することが多かった．⑥進展群9例中5例（56％）に腸管手術が施行された．

　Sixteen cases with Crohn's disease consisting solely of aphthoid lesions, which could be followed up for more than 3 years, were analyzed in order to investigate their long-term course. We obtained the following results : ① Nine of them (56 ％) had progressed to typical cases of Crohn's disease, with longitudinal ulcers and/or cobblestone appearances, and the others (44 ％) had not yet progressed that far. ② The mean serum C-reactive protein level of the progressing cases at the first visit was higher than that of the non-progressing ones, but not significantly. ③ None of the progressing cases had abdominal pain as the first symptom of Crohn's disease. ④ All progressing cases had anal lesions, and their frequency was significantly higher than those in the non-progressing ones. ⑤ The mean duration from the diagnosis to the appearance of typical lesions of Crohn's disease was 29.7 months in the progressing cases, but typical lesions appeared only in their ileum, cecum or colon. ⑥ Five of the 9 progressing cases had already undergone resections of the intestine due to complications of Crohn's disease.