コルヒチンにより下痢と脂肪の細胞内転送障害を示した1例

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タイトル別名
  • EVIDENCE THAT COLCHICINE INHIBITS CHYLOMICRON'S RELEASE FROM ABSORPTIVE CELLS OF THE DUODENUM
  • -A CASE REPORT-

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A 47-year-old man was administered 3 mg/day of colchicine because of his steroid resistent uveitis. After five days he suffered from watery diarrhea on which antidiarrheic had no effect. Duodenofiberscopy using Olympus GIF-D3 was performed and showed cluster of white villi and sparse scattered duodenal white spot in the second portion of the duodenum (Figure 4). Magnifying endoscopy with 0.5% methylene blue revealed mild atrophy of the intestinal villi (Figure 4). Crypts were also observed from the biopsied specimens under dissecting microscope (Figure 6) and scanning electron microscope (Figure 7). Furthermore biopsy specimens were also. taken from the duodenum three hours after oral administration of 20 ml of olive oil for electron microscopic study. This revealed characteristic vesicles containing fat droplets which were considered Goldi vesicles or lysosomes in the absorptive cells and we could not find chylomicrons in the intercellular spaces (Figure 9). This finding indicates that colchicine is detrimetal to microtubules and finally leads to inhibition of chylomicron's release out of the absorptive cells. This phenomenon was first described by Glickman et al based on experimental study in rats. We also reported in 1977 (Figure 1 & 2). This is the first report in human subject.

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