血便を繰り返したアミロイドーシスの1例

Primary Amyloidosis with Repeated Episodes of Hematochezia, Report of a Case

要旨　患者は81歳の男性で，10年来繰り返す血便がみられ，非特異性直腸・S状結腸炎として経過観察されていた．入院3日前より1日10回に及ぶ血便がみられ，入院後の大腸内視鏡検査では，直腸S状結腸に浮腫状粘膜に覆われた大小不同の隆起性病変および散在性の出血点，粘膜の易出血性が観察された．その生検組織より原発性アミロイドーシスと診断した．sulphasalazine投与3週間で下血は消退し，大腸X線像においても改善が認められた．

　The patient was an 81-year-old man with repeated episodes of hematochezia which had been considered due to non-specific proctosigmoiditis for 10 years. He visited our hospital complaining of frequent mucous bloody stools of 3 days' duration. Colonoscopic examination revealed polypoid lesions with edematous surface, scattered bleeding spots and mucosal friability in the proctosigmoid colon. Biopsy specimens showed histologically marked amyloid deposition in the lamina propria and submucosa of the colon by Congo-red staining after the treatment of KMnO₄. The patient was thus diagnosed as having primary amyloidosis. Hematochezia disappeared after administration of sulphasalazine for 3 weeks and the abnormalities found at admission on barium enema also improved remarkably to almost normal range.