Ileitis due to yersinia as a differential diagnosis of crohn's disease: case report
Ileite por yersinia como diagnóstico diferencial de doença de crohn: relato de caso
Palavras-chave:
Ileitis, Crohn's disease, Yersinia sp.Resumo
This report describes a case of ileitis caused by Yersinia sp. in a hospitalized patient who presented with severe abdominal pain in the right flank and iliac fossa, and chronic diarrhea. The initial hypothesis was Crohn's disease. Diseases that affect the intestine can be grouped under Inflammatory Bowel Disease (IBD), which refers to an inflammatory process that affects the gastrointestinal tract (with autoimmune characteristics). Crohn's disease (CD) and Ulcerative colitis (UC) account for about 80-90% of the causes. Other types of pathology, such as Behçet's disease, eosinophilic enterocolitis, and microscopic colitis (lymphocytic or collagenous), can also be causes, but they are much rarer than CD and UC. This case report is about a 23-year-old patient, admitted to a hospital in the city of Anápolis, GO, who presented with active ileitis, diarrhea, and enterorrhagia, asthenia, and weight loss. After extensive investigation—laboratory tests, echocardiogram, abdominal CT scan, and colonoscopy with lymph node biopsy—, the patient was diagnosed with Yersinia sp. infection. He was treated with antibiotics and discharged (after outpatient treatment) with an excellent response to treatment.
Downloads
Referências
HABR-GAMA, A., et al. Diretrizes em Foco. Doença de Crohn intestinal: manejo. Revista Associação Medicina Brasileira, vol. 57, no. 1, p.10-13, 2011.
VIDAL, M.A.N. Esquistossomose Retal – Aspectos Clínicos e Endoscópicos. Revista Brasileira de Coloproctologia, vol. 21, no. 2, p. 70-74, 2001.
Dilauro S., Crum-Cianflone N.F. Ileitis: when it is not Crohn's disease. Curr Gastroenterol Rep. 2010; 12:249-58.
Dudley T.H., Dean P.J. Idiopathic granulomatous appendicitis, or Crohn's disease of the appendix revisited. Hum Pathol. 1993; 24:595-601.
Imoto A., Murano M., Hara A., Narabayashi K., Ogura T., Ishida K., et al. Adult intussusception caused by Yersinia enterocolitica enterocolitis. Intern Med. 2012; 51:2545-9.
Lamps L.W., Madhusudhan K.T., Greenson J.K., Pierce R.H., Massoll N.A., Chiles M.C., et al. The role of Yersinia enterocolitica and Yersinia pseudotuberculosis in granulomatous appendicitis: a histologic and molecular study. Am J Surg Pathol. 2001; 25:508-15.
Lamps L.W., Madhusudhan K.T., Havens J.M., Greenson J.K., Bronner M.P., Chiles M.C., et al. Pathogenic Yersinia DNA is detected in bowel and mesenteric lymph nodes from patients with Crohn's disease. Am J Surg Pathol. 2003;27:220-7.
Zippi M., Colaiacomo M.C., Marcheggiano A., Pica R., Paoluzi P., Iaiani G., et al. Mesenteric adenitis caused by Yersinia pseudotubercolosis in a patient subsequently diagnosed with Crohn's disease of the terminal ileum. World J Gastroenterol. 2006; 12:3933-5.