CAJ | 학술논문

目的胶原性胃炎(coHagenous gastritis,CG)临床少见,现报道一例CG并进行文献复习.方法患者行胃镜检查,活检组织切片分别行HE染色、Masson染色、刚果红染色及Warthin-Starry染色;分析病例临床资料并进行随访.结果 1例20岁女性患者主因无规律上腹痛4年,伴腹胀、呃逆、体重明显下降2个月就诊.胃镜检查于角切迹及窦部可见白色结节(活检).病理诊断为胶原性胃炎,上皮下胶原带厚度为16.6-120.3μm,平均厚度43.8 μm,Masson染色阳性,刚果红染色阴性.给予泼尼松(20 mg/d)4周,配合促动力和胃黏膜保护药,患者食欲好转,呃逆减轻,体重略有增加.结论目前国外文献报道CG仅40余例,其发病机制尚不明确.综合本病例临床及组织病理学特点,符合儿童和青少年发病型CG.综合相关文献及本例治疗经验,无谷胶饮食和糖皮质激素可以有效改善患者症状.
목적 효원성위염(coHagenous gastritis,CG)림상소견,현보도일례CG병진행문헌복습.방법 환자행위경검사,활검조직절편분별행HE염색、Masson염색、강과홍염색급Warthin-Starry염색;분석병례림상자료병진행수방.결과 1례20세녀성환자주인무규률상복통4년,반복창、애역、체중명현하강2개월취진.위경검사우각절적급두부가견백색결절(활검).병리진단위효원성위염,상피하효원대후도위16.6-120.3μm,평균후도43.8 μm,Masson염색양성,강과홍염색음성.급여발니송(20 mg/d)4주,배합촉동력화위점막보호약,환자식욕호전,애역감경,체중략유증가.결론 목전국외문헌보도CG부40여례,기발병궤제상불명학.종합본병례림상급조직병이학특점,부합인동화청소년발병형CG.종합상관문헌급본례치료경험,무곡효음식화당피질격소가이유효개선환자증상.
Objective Collagenous gastritis is a rare entity, characterized by the deposition of a subepithelial collagen band with an inflammatory infiltrate in the mucosa.This report describes the first case of collagenous gastritis occurring in a young Chinese woman and reviews the literatures.Methods The patient underwent the gastroscopy screening, and the biopsy specimens were treated with HE staining, Masson staining, Congo red staining and Warthin-Starry staining.Patients' clinical data was discussed and followed up.Results A twenty-year-old girl had intermittent epigastric pain for 4 years, abdominal distention, hiccup and weight loss for two months.The gastric endoscopy revealed diffuse white nodular appearance of the mucosa in angular incisure and antrum.Pathologic examination of the gastric biopsies from the antrum and angular showed a subepithelial collagen deposition with moderate infiltrates of lymphoplasma cells and eosinophils of the lamina propria.The collagen band measured up to 120.3 μm (mean 43.8 μm).Prednisone 20 mg/d for 4 weeks led to clinical remission and weight gain.Conclusion There are about 40 cases in literatures to date, and the cause and pathogenesis of collagenous gastritis remain unknown.According to the clinical and pathological characteristics, the patient in this article is the subtype of collagenous gastritis that occurring in children and young adults.Specific therapy has not been established, the gluten-free diet and glucocorticosteroid may be helpful to relieve symptoms in collagenous gastritis patients.