警惕炎症性肠病与少见肠道疾病的鉴别诊断

doi:10.3877/cma.j.issn.2095-2015.2023.05.001

中华消化病与影像杂志(电子版) ›› 2023, Vol. 13 ›› Issue (05) : 273 -276. doi: 10.3877/cma.j.issn.2095-2015.2023.05.001

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警惕炎症性肠病与少见肠道疾病的鉴别诊断

朱风尚, 舍玲, 丁永年, 杨长青^†(

)

200065　上海，同济大学附属同济医院消化科；830063　乌鲁木齐，省部共建中亚高发病成因与防治国家重点实验室，新疆医科大学第二附属医院消化科
830063　乌鲁木齐，省部共建中亚高发病成因与防治国家重点实验室，新疆医科大学第二附属医院消化科
200065　上海，同济大学附属同济医院消化科

收稿日期:2023-07-23 出版日期:2023-10-01
通信作者: 杨长青
基金资助:
省部共建中亚高发病成因与防治国家重点实验室项目(SKL-HIDCA-2021-DX9); 新疆维吾尔自治区科技厅科技援疆项目(2021E02075)

Maintaining vigilance in the differential diagnosis of inflammatory bowel disease and rare bowel disorders

Fengshang Zhu, Ling She, Yongnian Ding, Changqing Yang^†()

Department of Gastroenterology, Tongji Hospital of Tongji University, Shanghai 200065, China; State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Gastroenterology, Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830063, China
State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Department of Gastroenterology, Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830063, China
Department of Gastroenterology, Tongji Hospital of Tongji University, Shanghai 200065, China

Received:2023-07-23 Published:2023-10-01
Corresponding author: Changqing Yang

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引用本文：

朱风尚, 舍玲, 丁永年, 杨长青. 警惕炎症性肠病与少见肠道疾病的鉴别诊断[J]. 中华消化病与影像杂志(电子版), 2023, 13(05): 273-276.

Fengshang Zhu, Ling She, Yongnian Ding, Changqing Yang. Maintaining vigilance in the differential diagnosis of inflammatory bowel disease and rare bowel disorders[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(05): 273-276.

近年，炎症性肠病(IBD)出现了过度诊断苗头。和诊断不足一样，IBD过度诊断同样弊端明显。目前临床大多高度重视与肠结核、肠型贝赫切特综合征、肠型淋巴瘤和缺血性结肠炎等常见疾病的鉴别，而较少重视IBD与少见肠道疾病的鉴别。本文结合目前的文献和团队经验，介绍了多种少见但极易误诊为IBD的肠道疾病，以呼吁警惕IBD与少见类IBD样疾病的鉴别诊断。

关键词: 炎症性肠病, 溃疡性结肠炎, 克罗恩病, 小肠疾病, 鉴别诊断

In recent years, there has been a trend towards of over-diagnosis in inflammatory bowel disease(IBD). Over-diagnosis, like under-diagnosis, also triggers endless consequences.In the clinical practice, most of the effort is focused on distinguishing IBD from the common diseases such as intestinal tuberculosis, intestinal Behcet′s syndrome, intestinal lymphoma and ischemic colitis.However, there is less awareness of the differential diagnosis between IBD and the rare intestinal diseases.Based on current literature and personal experience, this editorial introduces various rare intestinal diseases that are easily misdiagnosed as IBD, calling for vigilance in the differential diagnosis of IBD and rare IBD-like diseases.

Key words: Inflammatory bowel disease, Ulcerative colitis, Crohn′s disease, Intestinal diseases, Differential diagnosis

图8 憩室相关性结肠炎肿胀的黏膜红斑。

1	陈利，朱风尚，杨长青．当前炎症性肠病诊治中需注意的若干问题[J/OL]．中华消化病与影像杂志(电子版)，2019，9(3)：97-99.
2	Panarelli NC.Infectious Mimics of Inflammatory Bowel Disease[J]．Mod Pathol，2023，36(7)：100210.
3	中华医学会消化病学分会炎症性肠病学组．炎症性肠病诊断与治疗的共识意见(2018年，北京)[J]．中华消化杂志，2018，38(5)：292-311.
4	Jagirdhar GSK，Surani S．Non-clostridium difficile induced pseudomembranous colitis[J]．World J Clin Cases，2023，11(5)：979-988.
5	Tung W，Hays R．Atypical presentation of Clostridioides difficile pseudomembranous colitis with laboratory rejection of stool specimen[J]．BMJ Case Rep，2019，12(11)：e230629.
6	Valencia-Manrique JC，Adetiloye A，Alaameri R，et al.Non-Bleeding Colonic Ulcer as Initial Manifestation of Disseminated Cryptococcosis in a Patient With Human Immunodeficiency Virus[J]．Cureus，2021，13(8)：e17298.
7	Papa V，Giustiniani MC，Lopetuso LR，et al.Human herpesvirus 8-associated colonic Kaposi′s sarcoma during vedolizumab treatment in ulcerative colitis：a case report and review of the literature[J]．BMC Gastroenterol，2020，20(1)：76.
8	Costales-Cantrell JK，Dong EY，Wu BU，et al.Syphilitic Proctitis Presenting as a Rectal Mass：a Case Report and Review of the Literature[J]．J Gen Intern Med，2021，36(4)：1098-1101.
9	Rizza S，Mistrangelo M，Ribaldone DG，et al.Proctitis：a glance beyond inflammatory bowel diseases[J]．Minerva Gastroenterol Dietol，2020，66(3)：252-266.
10	郑跃杰，武庆斌，方峰，等．儿童抗生素相关性腹泻诊断、治疗和预防专家共识[J]．中华实用儿科临床杂志，2021，36(6)：424-430.
11	Villatoro-Villar M，Crowson CS，Warrington KJ，et al.Immunoglobulin A vasculitis associated with inflammatory bowel disease：a retrospective cohort study[J]．Scand J Rheumatol，2021，50(1)：40-47.
12	Lladó A，Oliveira J，Silva P，et al.Eosinophilic enteritis：a rare cause of diarrhoea [J]．BMJ Case Rep，2013：bcr2013201125.
13	Nishimura N，Mizuno M，Miyake M，et al.Primary Light-chain Amyloidosis Featuring Worm-like Small Bowel Polyposis[J]．Intern Med，2017，56(18)：2529-2530.
14	Ando K，Fujiya M，Ito T，et al.Atypical tumour-like involvement of the colon in secondary systemic amyloidosis which vanished after 1 month of observation[J]．BMJ Case Rep，2011：bcr0120113775.
15	Chen L，He Q，Luo M，et al.Clinical features of lupus enteritis：a single-center retrospective study[J]．Orphanet J Rare Dis，2021，16(1)：396.
16	Zhu XL，Xu XM，Chen S，et al.Lupus enteritis masquerading as Crohn′s disease[J]．BMC Gastroenterol，2019，19(1)：154.
17	McAlindon ME.Cryptogenic multifocal ulcerating stenosing enteritis and other under-recognised small bowel inflammatory enteropathies[J]．Curr Opin Gastroenterol，2022，38(3)：279-284.
18	Songtanin B，Chen JN，Nugent K．Microscopic Colitis：Pathogenesis and Diagnosis[J]．J Clin Med，2023，12(13)：4442.
19	Expósito Miranda M，García-Valdés L，Espigares-Rodríguez E，et al.Non-celiac gluten sensitivity：Clinical presentation，etiology and differential diagnosis[J]．Gastroenterol Hepatol，2023，46(7)：562-571.
20	Patel DA，Crain M，Pusic I，Schroeder MA.Acute Graft-versus-Host Disease：An Update on New Treatment Options[J]．Drugs，2023，83(10)：893-907.
21	Koga H，Shimizu K，Tarumi K，et al.Rectal mucosal prolapse syndrome as an unusual gastrointestinal manifestation of Sjögren′s syndrome：a case report[J]. J Med Case Rep，2009，3：85.
22	Freeman HJ.Segmental Colitis Associated with Diverticulosis(SCAD)[J]．Curr Gastroenterol Rep，2023，25(6)：130-133.
23	Sakhalkar OV，Goyal A，Abualruz AR.Segmental Colitis Associated With Diverticulosis[J]．Cureus，2023，15(5)：e38724.
24	Bellaguarda E，Hanauer S．Checkpoint Inhibitor-Induced Colitis[J]．Am J Gastroenterol，2020，115(2)：202-210.

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