Assuntos
Infecções por Vírus Epstein-Barr/virologia , Genes Codificadores da Cadeia gama de Receptores de Linfócitos T/genética , Herpesvirus Humano 4/isolamento & purificação , Doenças Linfáticas/virologia , Linfoma de Células T Periférico/virologia , Doença de Still de Início Tardio/virologia , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/genética , Rearranjo Gênico , Humanos , Doenças Linfáticas/complicações , Doenças Linfáticas/genética , Linfoma de Células T Periférico/complicações , Linfoma de Células T Periférico/genética , Masculino , Pessoa de Meia-Idade , Doença de Still de Início Tardio/complicações , Doença de Still de Início Tardio/genéticaRESUMO
A 51-year-old man was referred for body weight loss and lower right abdominal pain. Total colonoscopy revealed discrete and round ulceration at the ileocecal valve, and he was diagnosed with intestinal Behçet's disease (BD). By treatment with glucocorticoid, colchicine and salazosulfapyridine, the symptoms and ulceration were improved, but cessation of glucocorticoid resulted in relapse of ulceration at the terminal ileum. Long-term, low-dose treatment with clarithromycin (CAM) was implemented for chronic respiratory infections. Furthermore, we expected that this CAM treatment would also be effective in BD. During this long-term, low-dose treatment with CAM, discrete ulceration at the terminal ileum was never revealed by follow-up total colonoscopy once or twice per year for 7 years. No reports have described the effectiveness of this treatment in patients with intestinal BD; however, we confirm that long-term treatment with low-dose CAM might have clinical benefits for patients with intestinal BD.
RESUMO
A 53-year-old man was diagnosed as having idiopathic thrombocytopenic purpura (ITP). Hematochezia appeared under steroid therapy for ITP after the diagnosis of ITP 18 months. Colonoscopic study demonstrated inflamed rectal mucosa but there was no evidence of infectious colitis. The colonoscopic and pathological findings were compatible with ulcerative colitis (UC). There have been a few reports of patients with UC complicated by ITP, but in all except one report, UC preceded ITP. This is the third case in which ITP preceded UC and the first case in which the proctitis type of UC was complicated by ITP in Japan.