牛乳铁蛋白与克罗恩病:个案研究

D. Alexander, M. Iigo, Mohamed Abdelgied, K. Ozeki, S. Tanida, T. Joh, Satoru Takahashi, H. Tsuda
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引用次数: 9

摘要

2011年12月19日,一名22岁男性因腹痛、反复腹泻和体重减轻来到名古屋市立大学医院消化疾病科就诊。他被送进医院,并被诊断为克罗恩结肠炎。克罗恩病活动指数(CDAI)为415。开始用粒细胞分离、美沙拉嗪和阿达木单抗治疗。他的CDAI在12月30日是314,在1月5日是215。1月19日的结肠镜检查显示横结肠几乎完全缓解,直肠明显缓解。2月28日停止美沙拉嗪治疗,并指示患者每隔一周自我注射40mg阿达木单抗。4月10日CDAI为50,表明临床缓解。他最后一次自我注射阿达木单抗是在2012年4月24日,并开始每天服用1g牛乳铁蛋白(bLF)。2013年1月8日,他的CDAI为35。他继续每天服用1g bLF,没有接受克罗恩病的其他治疗。2015年9月7日的实验室血液检查显示没有疾病复发的迹象,2015年10月23日的结肠镜检查显示粘膜几乎完全愈合。本病例提示应进一步探讨摄入bLF以维持克罗恩病处于缓解状态。
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Bovine lactoferrin and Crohn's disease: a case study.
A 22-year-old male suffering from abdominal pain, repeated diarrhea, and weight loss visited the Digestive Disease Department of Nagoya City University Hospital on 19 December 2011. He was hospitalized and diagnosed with Crohn's colitis. His Crohn's Disease Activity Index (CDAI) was 415. Treatment by granulocyte apheresis, mesalazine, and adalimumab was started. His CDAI was 314 on 30 December and 215 on 5 January. A colonoscopic examination on 19 January showed almost complete remission in the transverse colon and marked remission in the rectum. Mesalazine therapy was stopped on 28 February, and the patient was instructed to self-inject 40 mg of adalimumab every other week. His CDAI was 50 on 10 April, indicating clinical remission. His last self-injection of adalimumab was on 24 April 2012, and he started taking 1 g of bovine lactoferrin (bLF) daily. His CDAI was 35 on 8 January 2013. He continued taking 1 g of bLF daily without any other treatment for Crohn's disease. Laboratory blood tests on 7 September 2015 showed no sign of disease recurrence, and a colonoscopic examination on 23 October 2015 showed almost complete mucosal healing. This case indicates that ingestion of bLF to maintain Crohn's disease in a remissive state should be further explored.
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