ENDOSCOPIC DIAGNOSIS OF HERPES SIMPLEX ESOPHAGITIS: REPORT OF A CASE

There have been many cases of herpes simplex esophagitis found in autopsies, only but a few cases where this disease was detected in a patient. In ourpresent case, an 81 year old female was admitted with complaints of nausea and anorexia. She was not given any immunosuppressant, nor did she receive...

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Published inJapanese Journal of National Medical Services Vol. 47; no. 12; pp. 990 - 994
Main Authors YOSHIOKA, Toshifumi, KONO, Hiroshi, OKA, Takefumi, KAWAGUCHI, Kenji, YAMASAKI, Hiroko, MORIMOTO, Shigeto
Format Journal Article
LanguageJapanese
Published Japanese Society of National Medical Services 1993
一般社団法人 国立医療学会
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ISSN0021-1699
1884-8729
DOI10.11261/iryo1946.47.990

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Abstract There have been many cases of herpes simplex esophagitis found in autopsies, only but a few cases where this disease was detected in a patient. In ourpresent case, an 81 year old female was admitted with complaints of nausea and anorexia. She was not given any immunosuppressant, nor did she receive nasogastric intubation. An upper gastrointestinal endoscopic examination showed multiple small punchedout ulcers with swollen margins in the middle portion of the esophagus, while an esophageal biopsy specimen revealed ballooning change and intranuclear inclusion (full type). Histochemical study with monoclonal antibody to herpes simplex virus verifyed the diagnosis of herpes simplex esophagitis. So far, in Japan, there have been, in the literatures, a total of 11 cases of herpes simplex esophagitis found in endoscopic examination, including our present case. Of these, four cases had malignant tumor as, underlying disease, one received an immunosuppressant after renal transplantation, two had hiatus hernia, and four had nasogastric intubation. However, there were three cases in which no clear underlying diseases were observed. Therefore, in performing endoscopy, it is important to pay a careful attention to possible presence of herpes simplex esophagitis.
AbstractList There have been many cases of herpes simplex esophagitis found in autopsies, only but a few cases where this disease was detected in a patient. In ourpresent case, an 81 year old female was admitted with complaints of nausea and anorexia.She was not given any immunosuppressant, nor did she receive nasogastric intubation. An upper gastrointestinal endoscopic examination showed multiple small punchedout ulcers with swollen margins in the middle portion of the esophagus, while an esophageal biopsy specimen revealed ballooning change and intranuclear inclusion (full type).Histochemical study with monoclonal antibody to herpes simplex virus verifyed the diagnosis of herpes simplex esophagitis.So far, in Japan, there have been, in the literatures, a total of 11 cases of herpes simplex esophagitis found in endoscopic examination, including our present case. Of these, four cases had malignant tumor as, underlying disease, one received an immunosuppressant after renal transplantation, two had hiatus hernia, and four had nasogastric intubation. However, there were three cases in which no clear underlying diseases were observed. Therefore, in performing endoscopy, it is important to pay a careful attention to possible presence of herpes simplex esophagitis. 単純ヘルペスウィルス(HSV)による食道炎は, 剖検例では多数の報告があるが生前に診断し得たという報告は比較的まれである. 症例は81歳女性で嘔気, 食欲不振にて来院. 内視鏡検査では, 中部食道に多数の類円形の浅い打ち抜き潰瘍を認め, 潰瘍部辺縁からの生検ではballooning change, full型核内封入体を認めた. 免疫組織学的検討では抗HSV血清に対し陽性を示しヘルペス食道炎と診断した. 本邦にて内視鏡的に診断し得たという報告は自験例を含め11症例であり, 基礎疾患では悪性腫瘍5例, 腎臓移植後の免疫抑制使用1例, 食道裂孔ヘルニアを有するもの2例, 胃管挿入4例であった. しかし明, ちかな基礎疾患を認めないものも2例あり, 内視鏡観察時には本疾患の存在にも注意する必要があると思われた.
There have been many cases of herpes simplex esophagitis found in autopsies, only but a few cases where this disease was detected in a patient. In ourpresent case, an 81 year old female was admitted with complaints of nausea and anorexia. She was not given any immunosuppressant, nor did she receive nasogastric intubation. An upper gastrointestinal endoscopic examination showed multiple small punchedout ulcers with swollen margins in the middle portion of the esophagus, while an esophageal biopsy specimen revealed ballooning change and intranuclear inclusion (full type). Histochemical study with monoclonal antibody to herpes simplex virus verifyed the diagnosis of herpes simplex esophagitis. So far, in Japan, there have been, in the literatures, a total of 11 cases of herpes simplex esophagitis found in endoscopic examination, including our present case. Of these, four cases had malignant tumor as, underlying disease, one received an immunosuppressant after renal transplantation, two had hiatus hernia, and four had nasogastric intubation. However, there were three cases in which no clear underlying diseases were observed. Therefore, in performing endoscopy, it is important to pay a careful attention to possible presence of herpes simplex esophagitis.
Author YOSHIOKA, Toshifumi
YAMASAKI, Hiroko
KONO, Hiroshi
MORIMOTO, Shigeto
KAWAGUCHI, Kenji
OKA, Takefumi
Author_FL 土河 野宏
山暗 弘子
岡 岳文
吉岡 敏文
川口 憲二
森本 茂人
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  organization: Department of Internal Medicine, National Iwakuni Hospitalf
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References 9) 笠原彰紀: 腎移植後に発症したヘルペス食道炎の1例, Gastroenterologial Endoscopy, 32: 881, 1990
3) Nash G and Ross JS: Herpetic esophagitis, a common . cause of esophageal ulceration, Hum. Path., 15: 339, 1974
12) 木附久雄: 穿孔性虫垂炎術後に発症したヘルペス食道炎の1例, 臨外, 46: 469, 1991
10) 疋島一徳: 健康成人のヘルペス食道炎, Gastroenterological Endoscopy, 32: 1584, 1984
1) Pearce JM and Dagradi A: Acute ulceration of esophagus with associated intranuclear inclusion bodies, Arch. Pathol., 35: 899, 1943
2) Buss DH and Scharyj M: Herpes virus infection of the esophagus and other visceral organs in adults, Am. J. Med., 66: 457, 1979
5) 川村寛: 生前に診断し得たヘルペス性食道炎の1例, 広島医学, 40: 21, 1987
13) 伊藤透: ヘルペス食道炎, 金沢医大誌, 11: 69, 1986
14) 戸塚盛計: ヘルペス食道炎が静脈瘤破裂の誘因と思われた肝細胞癌の一例, 肝臓, 30: 121, 1989
8) 石島直人: 2年間にわたり経過観察しえたヘルペス食道炎の一例, 三重医学, 34: 211, 1990
11) 佐宗克久: 細胞診により診断し得たヘルペス食道炎の1例, 日臨細胞会誌, 29: 207, 1990
4) 小武家俊博: ヘルペス食道炎6例の臨床病理学的検討, 広島医学, 38: 379, 1985
6) 森英俊: ヘルペス食道炎の1例, Gastroenterological Endoscopy, 29: 1832, 1987
7) 山腰雅宏: ヘルペス食道炎の1例. Gastroenterological Endoscopy, 31: 2309, 1989
References_xml – reference: 14) 戸塚盛計: ヘルペス食道炎が静脈瘤破裂の誘因と思われた肝細胞癌の一例, 肝臓, 30: 121, 1989
– reference: 4) 小武家俊博: ヘルペス食道炎6例の臨床病理学的検討, 広島医学, 38: 379, 1985
– reference: 3) Nash G and Ross JS: Herpetic esophagitis, a common . cause of esophageal ulceration, Hum. Path., 15: 339, 1974
– reference: 12) 木附久雄: 穿孔性虫垂炎術後に発症したヘルペス食道炎の1例, 臨外, 46: 469, 1991
– reference: 2) Buss DH and Scharyj M: Herpes virus infection of the esophagus and other visceral organs in adults, Am. J. Med., 66: 457, 1979
– reference: 5) 川村寛: 生前に診断し得たヘルペス性食道炎の1例, 広島医学, 40: 21, 1987
– reference: 6) 森英俊: ヘルペス食道炎の1例, Gastroenterological Endoscopy, 29: 1832, 1987
– reference: 13) 伊藤透: ヘルペス食道炎, 金沢医大誌, 11: 69, 1986
– reference: 1) Pearce JM and Dagradi A: Acute ulceration of esophagus with associated intranuclear inclusion bodies, Arch. Pathol., 35: 899, 1943
– reference: 10) 疋島一徳: 健康成人のヘルペス食道炎, Gastroenterological Endoscopy, 32: 1584, 1984
– reference: 11) 佐宗克久: 細胞診により診断し得たヘルペス食道炎の1例, 日臨細胞会誌, 29: 207, 1990
– reference: 9) 笠原彰紀: 腎移植後に発症したヘルペス食道炎の1例, Gastroenterologial Endoscopy, 32: 881, 1990
– reference: 7) 山腰雅宏: ヘルペス食道炎の1例. Gastroenterological Endoscopy, 31: 2309, 1989
– reference: 8) 石島直人: 2年間にわたり経過観察しえたヘルペス食道炎の一例, 三重医学, 34: 211, 1990
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Snippet There have been many cases of herpes simplex esophagitis found in autopsies, only but a few cases where this disease was detected in a patient. In ourpresent...
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jstage
SourceType Publisher
StartPage 990
SubjectTerms esophagitis
herpes simplex virus upper gastrointestinal endoscopy
上部消化管内視鏡検査
単純ヘルペズウイルス
食道炎
Title ENDOSCOPIC DIAGNOSIS OF HERPES SIMPLEX ESOPHAGITIS: REPORT OF A CASE
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