食管狭窄是贝赫切特病的首发症状:病例报告和文献综述

IF 1 Q4 RHEUMATOLOGY
Samaher Almousa , Aya Alhalaki , Ali Ahmad , Adnan Abdulhaleem , Ramy Khazem
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引用次数: 0

摘要

导言贝赫切特病(BD)是一种病因不明的多器官炎症性血管疾病,可影响任何大小和类型的血管。报告一例以食管狭窄为首发症状的贝赫切特病病例,并与世界范围内报告的病例进行比较。病例介绍 一位 30 岁的叙利亚男性患者出现吞咽困难、吞咽困难,体重下降 20 公斤。他有复发性口腔溃疡病史,其他方面健康。经检查,他面色苍白、脱水,全身检查正常。血液检查显示贫血(血红蛋白 10.5 mg/dl)、红细胞沉降率(ESR)(90 mm/1sthr)和 C 反应蛋白(CRP)(98 mg/dl)水平升高。上消化道内窥镜检查显示,食管上括约肌轻度溃疡、水肿和粘膜增厚,导致食管狭窄。活检显示为非特异性炎症,无肉芽肿或恶性肿瘤迹象。住院期间,他出现了生殖器溃疡和咯血,胸部计算机断层扫描显示他患有肺血管炎。患者被诊断为肺结核,接受了甲基强的松龙和环磷酰胺治疗,病情明显好转。两个月后,他可以正常吞咽,PEG 管被拔除,随访一年后没有复发。他继续服用硫唑嘌呤 100 克/天和泼尼松龙 7.5 毫克/天。EBD 很罕见,可导致残疾。EBD 的早期诊断和适当治疗对改善预后至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Esophageal stenosis as an initial presentation of Behçet’s disease: A case report and literature review

Introduction

Behçet’s disease (BD) is a multiorgan inflammatory vascular disease of unknown etiology, affecting vessels of any size and type. While, gastrointestinal involvement in BD is uncommon, esophageal Behçet’s disease (EBD) is rarely reported, especially in the Mediterranean region.

Aim of the work

To report a case with esophageal stenosis as an initial presentation of BD and compare to reported cases worldwide.

Case presentation

A 30-year-old Syrian male presented with dysphagia, odynophagia with weight loss 20 kg. He had a history of recurrent oral ulcers and was otherwise healthy. On examination he appeared pale, dehydrated with normal systemic examination. Blood tests revealed anemia (hemoglobin 10.5 mg/dl), elevated erythrocyte sedimentation rate (ESR) (90 mm/1sthr) and C-reactive protein (CRP)(98 mg/dl)levels. Upper gastrointestinal endoscopy showed mild ulceration with edema and mucosal thickness at the upper sphincter of the esophagus, leading to stenosis. Biopsy showed nonspecific inflammation, without granulomas or signs of malignancy. Percutaneous endoscopic gastrostomy (PEG) tube was placed and during hospitalization he developed genital ulcers and hemoptysis, with chest computed tomography revealing pulmonary vasculitis. The patient was diagnosed with BD, and treated with methylprednisolone and cyclophosphamide, leading to significant improvement. After two months he could swallow normally, and the PEG tube was removed with no recurrence after one year follow-up. He was maintained on azathioprine 100 g/day and prednisolone 7.5 mg/day.

Conclusion

BD is a diagnostic challenge due to its diverse manifestations and geographic variations. EBD is rare and can cause disability. Early diagnosis of EBD and appropriate treatment are crucial for improving outcomes.

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来源期刊
Egyptian Rheumatologist
Egyptian Rheumatologist RHEUMATOLOGY-
CiteScore
2.00
自引率
22.20%
发文量
77
审稿时长
39 weeks
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