크론병에서 발생한 위장관 아밀로이드증 1예
A Case of Gastrointestinal Amyloidosis as a Complication of Crohn’s Disease
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
아밀로이드증은 아밀로이드라는 불용성의 섬유단백이 세포 외에 침착한 질환으로 침범된 장기의 부전을 일으킬 수 있다. 속발성 아밀로이드증은 만성 염증이나 감염 질환에 관련하여 생기는 질환으로 신장, 간, 골수, 위장관 등에서 발생한다. 위장관은 아밀로이드증이 흔히 침범하는 장기 중 하나로, 침범한 위치에 따라 다양한 증상과 임상경과를 보인다. 크론병에서 발생한 속발성 아밀로이드증은 드물지만 불량한 예후를 보이며 남자에서 흔하다. 저자들은 7년 전 크론병 진단 후 치료 중인 59세 남자가 반복되는 설사와 복통으로 내원하여 위, 회장 말단과 대장에서 시행한 점막 조직 생검을 통해 속발성 아밀로이드증으로 진단한 1예를 경험하여서 문헌고찰과 함께 보고한다.
Abstract
Amyloidosis is a disorder resulting from extracellular deposition of insoluble fibrils and causes dysfunction in many organs. Secondary amyloidosis, caused by chronic infectious and inflammatory disease, may involve the kidneys, liver, bone marrow and gastrointestinal tract. Involvement of the gastrointestinal tract is common and presents various symptoms according to location. Amyloidosis as a complication of Crohn’s disease is a rare but serious complication that may worsen the prognosis. We report a case of gastrointestinal amyloidosis in a 59-year-old male patient with Crohn’s disease that was diagnosed with an endoscopic forceps biopsy of the stomach, terminal ileum and colon.
참고문헌 (20)
- Gorevic PD, "Amyloidosis", Annu Rev Med, 32, pp.261~271 (1981)
- Falk RH, "The systemic amyloidoses", N Engl J Med, 337, pp.898~909 (1997)
- Strege RJ, "Diagnosis and immunohistochemical classification of systemic amyloidoses. Report of 43 cases in an unselected autopsy series", Virchows Arch, 433, pp.19~27 (1998)
- Greenstein AJ, "Amyloidosis and inflammatory bowel disease. A 50-year experience with 25 patients", Medicine, 71, pp.261~270 (1992)
- 진규복, "크론씨병에 동반된 속발성 신아밀로이드증", 대한내과학회지, 70(3), pp.309~312 (2006), 대한내과학회
- Lovat LB, "Long-term survival in systemic amyloid A amyloidosis complicating Crohn's disease", Gastroenterology, 112, pp.1362~1365 (1997)
- Enriquez R, "Crohn's disease with amyloid A amyloidosis and nephrotic syndrome", Nephron, 81, pp.123~124 (1999)
- Saitoh O, "Renal amyloidosis as a late complication of Crohn's disease: a case report and review of the literature from Japan", World J Gastroenterol, 6, pp.461~464 (2000)
- Wester AL, "Secondary amyloidosis in inflammatory bowel disease: a study of 18 patients admitted to Rikshospitalet University Hospital, Oslo, from 1962 to 1998", Inflamm Bowel Dis, 7, pp.295~300 (2001)
- Rashid H, "The association of renal amyloidosis with regional enteritis (Crohn's disease)--report of two cases and review of the literature", Clin Nephrol, 14, pp.154~157 (1980)
- Sattianayagam PT, "Systemic amyloidosis and the gastrointestinal tract", Nat Rev Gastroenterol Hepatol, 6, pp.608~617 (2009)
- Kluve-Beckerman B, "A pulse-chase study tracking the conversion of macrophage-endocytosed serum amyloid A into extracellular amyloid", Arthritis Rheum, 46, pp.1905~1913 (2002)
- Menke DM, "Symptomatic gastric amyloidosis in patients with primary systemic amyloidosis", Mayo Clin Proc, 68, pp.763~767 (1993)
- Hayman SR, "Primary systemic amyloidosis: a cause of malabsorption syndrome", Am J Med, 111, pp.535~540 (2001)
- 문원, "위장관 유전분증의 임상 및 내시경 소견", Clinical Endoscopy, 31(4), pp.216~220 (2005), 대한소화기내시경학회
- Tada S, "Endoscopic and biopsy findings of the upper digestive tract in patients with amyloidosis", Gastrointest Endosc, 36, pp.10~14 (1990)
- Duston MA, "Diagnosis of amyloidosis by abdominal fat aspiration. Analysis of four years' experience", Am J Med, 82, pp.412~414 (1987)
- Hawkins PN, "Studies with radiolabelled serum amyloid P component provide evidence for turnover and regression of amyloid deposits in vivo", Clin Sci, 87, pp.289~295 (1994)
- Gillmore JD, "Amyloid load and clinical outcome in AA amyloidosis in relation to circulating concentration of serum amyloid A protein", Lancet, 358, pp.24~29 (2001)
- Park YK, "Systemic amyloidosis with Crohn's disease treated with infliximab", Inflamm Bowel Dis, 14, pp.431~432 (2008)