摘要
Entamoeba histolytica colitis can mimic Crohn’s disease. However, a fulminant infection can be life-threatening, especially after exposure to systemic steroids. We present a case of the patient who was initially diagnosed with ileocolonic Crohn’s disease, but developed a hepatic E histolytica abscess while undergoing anti-TNF therapy. After revision of the initial diagnostic biopsies, the diagnosis was questioned and E histolytica was confirmed using PCR and histopathology. As intestinal amoebiasis is the most common form of amoebic infection, care should be taken in case of refractory IBD or at initial diagnosis in patients who travelled to endemic areas. We therefore discuss the epidemiology, clinical features, diagnostic tools and pathophysiology of E Histolytica in order to raise awareness among gastroenterologists treating patients with inflammatory bowel disease.
摘要译文
溶组织内阿米巴结肠炎可以模仿克罗恩病。然而，暴发性感染可能危及生命，特别是在接触全身性类固醇后。我们提出了一例患者，该患者最初被诊断出患有回肠结肠克罗恩病，但在接受抗TNF治疗时出现了肝脏溶组织内阿米巴脓肿。在对初始诊断活组织检查进行修订后，对诊断进行了质疑，并使用PCR和组织病理学确认了溶组织内阿米巴。由于肠道阿米巴病是最常见的阿米巴感染形式，因此在患有难治性IBD的情况下或在前往流行地区的患者的初步诊断时应该小心。因此，我们讨论了E Histolytica的流行病学，临床特征，诊断工具和病理生理学，以提高胃肠病学家对炎症性肠病患者的认识。
Bram Verstockt[1];Séverine Vermeire[2];Gert Van Assche[3];Marc Ferrante[4]. When IBD is not IBD[J]. Scandinavian Journal of Gastroenterology, 2018,53(9): 1085-1088