TY - JOUR A2 - Giouleme, Olga I. AU - Aggarwal, Soorya N. AU - Cavanagh, Yana AU - Wang, Lan AU - Akmal, Amer AU - Grossman, Matthew A. PY - 2019 DA - 2019/05/20 TI -上消化道克罗恩病:SP - 2708909 VL - 2019 AB -上消化道主导型克罗恩病(CD)仍是一种难以捉摸的临床疾病，表现为症状局限或模糊，避免了临床的怀疑，延迟了后续的诊断评估。因此，它并没有得到广泛的描述，也缺乏明确的诊断或管理建议。标准的IBD评估包括血清学检查、影像学检查和内窥镜检查最初可能没有效果。此外，对于无长期疾病的患者，内镜评估可能大致正常。我们描述一个18岁的男性谁提出只有不明原因，持续缺铁性贫血。广泛的门诊测试包括标准活检的多内镜评估是无效的。最终，粪钙保护蛋白阳性促使小肠内镜下粘膜切除术(EMR)，以获得更大、更深的组织标本。黏膜呈粗卵石状，组织病理学显示局灶性隐窝脓肿，固有层慢性炎症，浅表凹上皮的再生改变与乳糜泻一致。该患者的病例表明，对于不明原因或持续性缺铁性贫血的患者，需要高度怀疑乳糜泻。 Persistent investigation yielded an elevation in fecal calprotectin suggesting underlying gastrointestinal inflammation and prompted advanced endoscopic evaluation with EMR. Waxing and waning tissue findings are characteristic of CD and pose a unique challenge in patients with upper gastrointestinal predominant pathology. As such, diligent workup including laboratory evaluation, imaging, and serial endoscopy is critical to establish pathology and dictate subsequent management in IBD, especially upper gastrointestinal tract predominant CD. SN - 2090-6528 UR - https://doi.org/10.1155/2019/2708909 DO - 10.1155/2019/2708909 JF - Case Reports in Gastrointestinal Medicine PB - Hindawi KW - ER -