胃と腸49巻3号

2014年03月発行

今月の主題 消化管アミロイドーシスを見直す 主題

全身性アミロイドーシスの分類・病態と治療

著者： 加藤修明¹ 池田修一¹

所属機関： ¹信州大学医学部脳神経内科，リウマチ・膠原病内科

ページ範囲：P.278 - P.285

要旨　アミロイドーシスは，アミロイドと呼ばれる細線維性蛋白が全身の諸臓器へ沈着して，臓器障害を来す疾患の総称である．本疾患は前駆蛋白質の化学的性状と，全身性か限局性かにより分類される．限局性アミロイドーシスは沈着局所に障害を来すが，患者の生命予後は良好である．消化管，特に胃・十二指腸とS状結腸・直腸は限局性アミロイドーシスで侵されやすい部位である．全身性アミロイドーシスは，心臓，腎臓，消化管，末梢神経などを障害して，生命予後が不良な疾患である．しかし近年，本疾患では体内におけるアミロイド前駆蛋白の産生を阻止する治療により，いったん沈着したアミロイドが患者体内から退縮することが見い出され，根治療法への道が開けてきた．

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