Biegunka autoimmunologiczna

Katarzyna Popińska, Małgorzata Łyszkowska, Jarosław Kierkuś, Jerzy Socha

Streszczenie
Introduction: Autoimmune enteropathy can be defined as a clinical disorder in general characterized by severe diarrhoea associated with small bowel atrophy and circulating antienterocyte antibodies. A variety of immunosupression therapies with or without parenteral nutrition can be used with variable degrees of success. Parenteral nutrition related infections contribute to mortality of this disorder.
Case reports: During last 10 years we have studied 3 children with autoimmune enteropathy (2 males, 1 female). The protracted diarrhoea began at 1-6 months of their life. All children were initially treated by total parenteral nutrition folowed by the introduction of an oligopeptides diet. The children were treated with immunosuppressive drugs: prednisolon, azathioprine, cyclosporine. One child (1) responded to cyclosporine, second (2) received cyclosporine and parenteral nutrition, third (3) child was treated with prednisolone, azathioprine, cyclosporine and parenteral nutrition. Two children (2) and (3) died because of general infection caused by parenteral nutrition in age of 4 and 2 years. (1) child, currently 11 years old boy is treated with prednisolone and cyclosporine. Autoimmune enteropathy is complicated by HCV infection with cirrhosis hepatis and psoriasis.
Conclusions: Autoimmune enteropathy occurs rather rarelly. Immunosuppressive methods of treatment with parenteral nutrition can induce clinical remission. Most beneficial in this disorder is cyclosporine. Septic complication of parenteral nutrition contribute to the mortality of this disorder.

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