혈성설사를 동반한 호산구성 대장염 1예
Eosinophilic Colitis Presenting with Bloody Diarrhea: Case Report
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초록
호산구성 대장염은 호산구성 위장관 질환의 드문 아형이며, 두 연령대에서 호발하는데 한 그룹은 영아형으로 평균연령이 60일 정도이며, 다른 한 그룹은 청소년기와 성인 초기에 호발한다. 호산구성 대장염에서 아토피와 알레르기가 50%에서 관련되며, 아토피형과 비아토피형으로 나뉘는데 비아토피형은 아주 드물다. 저자들은 이전에 다른 병력이 없었으며 특별한 자각증상 없이 지내던 환자가 혈성설사와 하복통으로 내원하여 혈액검사에서 말초혈액의 호산구증가증과 정상범위의 혈청 IgE 소견을 보였고, 대장내시경검사에서 구불결장과 직장에 출혈성 미란과 궤양이 관찰되었으며 조직 검사에서 점막 고유층에 미만성 호산구 침윤 소견을 보여 비아토피형의 호산구성 대장염으로 진단하였고, 보존 치료에 반응이 없어 전신 스테로이드 치료로 호전을 보인 증례를 경험하여 보고한다.
Abstract
Eosinophilic colitis is a chronic inflammatory bowel condition of unknown etiology and a rare subtype of eosinophilic gastrointestinal diseases. It is characterized by gastrointestinal symptoms and increased eosinophil numbers in the intestinal mucosa and absence of other potential causes of gastrointestinal eosinophilia. The clinical presentation is varied and depends on the involved layer of the large intestine. There are no confirmatory laboratory tests, and the morphologic evaluation of biopsies or surgical specimens is required to confirm the diagnosis. A 65-year-old man presented with an 8 day duration of bloody diarrhea and lower abdominal pain. The patient was diagnosed with eosinophilic colitis by histopathological evaluation of biopsies and was further categorized as a nonatopic variant associated with non-IgE-mediated reaction. The patient was successfully treated with systemic corticosteroid for 2 weeks. On follow-up after 9 months, the patient remained well without relapse or new lesions.
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