RESUMO
Protein-losing gastroenteropathy (PLG) can occur as a manifestation of various diseases including autoimmune disorders, and optimal therapy of these underlying diseases may be the only effective remedy for PLG. In the present report, we describe a case of a 54-year-old woman with PLG associated with an autoimmune disease, presumably CREST syndrome. She failed to respond to steroid treatment. Subsequently, cyclosporine was initiated, which resulted in a rapid recovery. The patient was successfully treated with low-dose cyclosporine for five years. There has not been, to our knowledge, any report of PLG successfully treated with cyclosporine. Cyclosporine therapy may be effective not only in inducing but also in maintaining complete remission in patients with autoimmune-associated PLG, especially refractory or intolerable to steroids and/or immunosuppressive therapies.
Assuntos
Síndrome CREST/tratamento farmacológico , Ciclosporina/administração & dosagem , Imunossupressores/administração & dosagem , Enteropatias Perdedoras de Proteínas/diagnóstico , Enteropatias Perdedoras de Proteínas/tratamento farmacológico , Administração Oral , Biópsia por Agulha , Síndrome CREST/complicações , Síndrome CREST/diagnóstico , Síndrome CREST/imunologia , Relação Dose-Resposta a Droga , Esquema de Medicação , Duodeno/diagnóstico por imagem , Duodeno/patologia , Feminino , Seguimentos , Humanos , Imuno-Histoquímica , Assistência de Longa Duração , Pessoa de Meia-Idade , Enteropatias Perdedoras de Proteínas/complicações , Enteropatias Perdedoras de Proteínas/imunologia , Cintilografia , Medição de Risco , Índice de Gravidade de Doença , Estômago/diagnóstico por imagem , Estômago/patologia , Resultado do TratamentoAssuntos
Doença de Crohn/complicações , Volvo Intestinal/complicações , Adulto , Colonoscopia , Humanos , MasculinoRESUMO
A 36-year-old woman with ulcerative colitis presented with fever, chest and back pain, and fatigue sensation of the arm. Her upper limb pulses were absent. Angiography showed multiple aneurysms of the aorta and its branches, consistent with Takayasu's arteritis. She showed HLA-B35 but no B52, which is the typical haplotype among the coexistence cases of both diseases. Prednisolone was effective. The possible pathogenic association of the disorders is discussed.