山东大学学报 (医学版) ›› 2023, Vol. 61 ›› Issue (9): 118-124.doi: 10.6040/j.issn.1671-7554.0.2023.0217
• 临床医学 • 上一篇
符晓莉,魏绪霞,徐俊杰,薛宁,张乐,陈红苓
FU Xiaoli, WEI Xuxia, XU Junjie, XUE Ning, ZHANG Le, CHEN Hongling
摘要: 目的 探讨儿童自身免疫性肠病(AIE)的临床特点、病理组织学特征、诊断、治疗及预后。 方法 回顾性分析2021年12月收治于山东大学附属儿童医院消化科的1例AIE患儿的临床资料。分别以“儿童自身免疫性肠病”“自身免疫性肠病”“autoimmune enteropathy in children”“autoimmune enteropathy”为关键词检索中国知网、万方数据知识服务平台、pubmed数据库自建库至2023年3月的相关文献,总结儿童AIE的临床特点、病理组织学特征、诊疗及预后。 结果 患儿,女,3岁10个月,因腹泻18 d就诊,根据患儿难治性水样泻、电解质紊乱、低蛋白血症、营养不良等临床症状及典型病理改变,排除感染性腹泻、乳糜泻、极早发型炎症性肠病、先天性遗传代谢病及免疫缺陷病,确诊为儿童AIE。予甲泼尼龙治疗8个月余,停药复发,遂予他克莫司治疗,随访至2023年3月(他克莫司治疗6个月余),病情好转。检索符合条件的国外儿童AIE病例共66例,中国儿童AIE仅5例。 结论 儿童AIE发病率低,临床主要以难治性腹泻为主要表现,常规治疗及回避饮食无效,病理组织学特征性改变为明确诊断提供了重要依据,早期诊断并及时治疗有助于改善预后。
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