Cryptogenic multifocal ulcerating stenosing enteritis and other under-recognised small bowel inflammatory enteropathies

McAlindon Mark E.

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Cryptogenic multifocal ulcerating stenosing enteritis and other under-recognised small bowel inflammatory enteropathies

机译：Cryptogenic multifocal ulcerating stenosing enteritis and other under-recognised small bowel inflammatory enteropathies

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Purpose of review Capsule endoscopy and more sensitive radiological techniques have resulted in more enteropathies being detected. A rare disease of unknown aetiology, 'cryptogenic multifocal ulcerating stenosing enteritis' or 'chronic nonspecific multiple ulcers of the small intestine' (CNSU), has long been recognised. This review aims to describe how disease can be better diagnosed and differentiated from other small bowel inflammatory disorders. Recent findings Genetic studies have shown that some patients with CNSU (the term used in Japanese studies) express SLCO2A1 gene mutations, a gene which encodes a prostaglandin transporter expressed on vascular endothelium, allowing a more specific diagnosis of 'chronic enteropathy associated with SLCO2A1'. Mutations in the PLA2G4A gene result in cytosolic phospholipase A(2 alpha) deficiency and reduced arachidonic acid for prostaglandin synthesis leading to a severe ulcerating, stenosing and fistulating small bowel disease. A 'prostaglandin-related enteropathy' should be considered in patients with atypical small bowel ulceration and stenosis. Genetic analysis will allow the detection of SLCO2A1 and PLA2G4A gene mutations. However, a careful history of medication use and a urinary metabolite screen may reveal the use of nonsteroidal anti-inflammatory drugs, a common cause of small bowel injury which is well recognised as being mediated by prostaglandin inhibition.

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《Current opinion in gastroenterology》 |2022年第3期|279-284|共6页
作者
McAlindon Mark E.;
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作者单位

Acad Dept Gastroenterol & Hepatol,Sheffield Teaching Hosp NHS Fdn Trust;

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原文格式 PDF
正文语种英语
中图分类消化系及腹部疾病;
关键词
chronic nonspecific multiple ulcers of the small bowel; crypto-genic multifocal ulcerating stenosing enteritis; cryptogenic multifocal ulcerous stenosing enteritis; nonsteroidal anti-inflammatory drug enteropathy; NONSPECIFIC MULTIPLE ULCERS; SMALL-INTESTINE; FEATURES;

Cryptogenic multifocal ulcerating stenosing enteritis and other under-recognised small bowel inflammatory enteropathies

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