SUCCESSFUL TREATMENT WITH CYCLOPHOSPHAMIDE PULSE THERAPY IN A CASE OF AUTOIMMUNE PROTEIN-LOSING ENTEROPATY

Kiyoshi HOTTA; Yasuhiro FUJIWARA; Kazuki YAMAMORI; Atushi ITANI; Fiji SASAKI; Kenji WATANABE; Masatsugu SHIBA; Kazunari TOMINAGA; Toshio WATANABE; Shiro NAKAMURA; Nobuhide OSHITANI; Kazuhide HIGUCHI; Tetsuo ARAKAWA

doi:10.11280/gee1973b.47.200

Kiyoshi HOTTA, Yasuhiro FUJIWARA, Kazuki YAMAMORI, Atushi ITANI, Fiji SASAKI, Kenji WATANABE, Masatsugu SHIBA, Kazunari TOMINAGA, Toshio WATANABE, Shiro NAKAMURA, Nobuhide OSHITANI, Kazuhide HIGUCHI, Tetsuo ARAKAWA

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Kiyoshi HOTTA
Department of Gastroenterology, Osaka City University, Graduate School of Medicine, Osaka, Japan.
Yasuhiro FUJIWARA
Department of Gastroenterology, Osaka City University, Graduate School of Medicine, Osaka, Japan.
Kazuki YAMAMORI
Department of Gastroenterology, Osaka City University, Graduate School of Medicine, Osaka, Japan.
Atushi ITANI
Department of Gastroenterology, Osaka City University, Graduate School of Medicine, Osaka, Japan.
Fiji SASAKI
Department of Gastroenterology, Osaka City University, Graduate School of Medicine, Osaka, Japan.
Kenji WATANABE
Department of Gastroenterology, Osaka City University, Graduate School of Medicine, Osaka, Japan.
Masatsugu SHIBA
Department of Gastroenterology, Osaka City University, Graduate School of Medicine, Osaka, Japan.
Kazunari TOMINAGA
Department of Gastroenterology, Osaka City University, Graduate School of Medicine, Osaka, Japan.
Toshio WATANABE
Department of Gastroenterology, Osaka City University, Graduate School of Medicine, Osaka, Japan.
Shiro NAKAMURA
Department of Gastroenterology, Osaka City University, Graduate School of Medicine, Osaka, Japan.
Nobuhide OSHITANI
Department of Gastroenterology, Osaka City University, Graduate School of Medicine, Osaka, Japan.
Kazuhide HIGUCHI
Department of Gastroenterology, Osaka City University, Graduate School of Medicine, Osaka, Japan.
Tetsuo ARAKAWA
Department of Gastroenterology, Osaka City University, Graduate School of Medicine, Osaka, Japan.

JOURNAL FREE ACCESS

2005 Volume 47 Issue 2 Pages 200-205

DOI https://doi.org/10.11280/gee1973b.47.200

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Abstract

A 41-year-old man was admitted to our hospital because of face and leg edema. Blood examination revealed hypoalbuminemia and positive reaction for anti-nuclear antibodies and anti-Sm antibodies. Abdominal scintigram using 99mTc-labeled human albumin revealed abnormal radioactivity in the ascending and transverse colon, suggesting albumin losing from terminal ileum or ascending colon. Colonoscopy revealed slight reddish mucosa and histology of biopsy specimen showed mild edema and inflammatory cell infiltration. Immunofluorescense study revealed deposition of C3 in the endothelium of colonic mucosa. Diagnosis of autoimmune protein-losing enteropathy was made. Steroid therapy was not effective and cyclophosphamide pulse therapy resulted in a significant recovery of serum albumin level and improvement of clinical symptoms.

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