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논문 기본 정보

자료유형
학술저널
저자정보
Haruka Miyazaki (Kobe University Hospital) Namiko Hoshi (Kobe University Hospital) Michitaka Kohashi (Kobe University Hospital) Eri Tokunaga (Kobe University Hospital) Yuna Ku (Kobe University Hospital) Haruka Takenaka (Kobe University Hospital) Makoto Ooi (Kobe University Hospital) Nobuyuki Yamamoto (Kobe University Graduate School of Medicine) Suguru Uemura (Kobe University Graduate School of Medicine) Noriyuki Nishimura (Kobe University Graduate School of Health Sciences) Kazumoto Iijima (Kobe University Graduate School of Medicine) Keisuke Jimbo (Juntendo University Faculty of Medicine) Tsubasa Okano (Tokyo Medical and Dental University (TMDU)) Akihiro Hoshino (Tokyo Medical and Dental University (TMDU)) Kohsuke Imai (Tokyo Medical and Dental University (TMDU)) Hirokazu Kanegane (Tokyo Medical and Dental University (TMDU)) Ichiro Kobayashi (KKR Sapporo Medical Center) Yuzo Kodama (Kobe University Hospital)
저널정보
대한장연구학회 Intestinal research Intestinal research Vol.20 No.1
발행연도
2022.1
수록면
144 - 149 (6page)
DOI
10.5217/ir.2020.00041

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Autoimmune enteropathy (AIE) is a rare disease, characterized by intractable diarrhea, villous atrophy of the small intestine, and the presence of circulating anti-enterocyte autoantibodies. Immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome, and mutations in FOXP3, which is a master gene of regulatory T cells (Tregs), are major causes of AIE. Recent studies have demonstrated that mutations in other Treg-associated genes, such as CD25 and CTLA4, show an IPEX-like phenotype. We present the case of a 13-year-old girl with CTLA4 haploinsufficiency, suffering from recurrent immune thrombocytopenic purpura and intractable diarrhea. We detected an autoantibody to the AIE-related 75 kDa antigen (AIE-75), a hallmark of the IPEX syndrome, in her serum. She responded well to a medium dose of prednisolone and a controlled dose of 6-mercaptopurine (6-MP), even after the cessation of prednisolone administration. Serum levels of the soluble interleukin-2 receptor and immunoglobulin G (IgG) were useful in monitoring disease activity during 6-MP therapy. In conclusion, autoimmune-mediated mechanisms, similar to the IPEX syndrome, may be involved in the development of enteropathy in CTLA4 haploinsufficiency. Treatment with 6-MP and monitoring of disease activity using serum levels of soluble interleukin-2 receptor and IgG is suggested for such cases.

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