岡山医学会Acta Medica Okayama0030-15581051-21993アレルギー性胃腸症の病態に関する研究 第1編 腹部超音波走査法による抗原経口負荷試験に関する検討8795ENYujiToyotaPathogenesis of allergic gastroenteropathy involves various antigen-mediated allergic reactions through a defensive mechanism of the digestive tract. The conventional method of the diagnosis generally involves the exclusion-provocation test of causative food and the judgement based on only subjective symptoms. A diagnostic method based on objective parameters has not been established yet. To establish an objective diagnostic method, ultrasonography was applied to 3 patients in whom chicken eggs and milk had been clinically diagnosed as the antigens during the oral loading test of appropriate antigen extract. After oral loading of the causative antigen extract, the gastric movements were observed by ultrasonography from 30 minutes before loading until 120 minutes after loading. The total number of peristaltic movements were then measured during every 30 minuites as an indicator of acceleration of gastric peristalic movenents. All 3 cases showed a marked acceleration of gastric peristaltic movements as well as several abdominal symptoms such as abdominal pain and diarrhea at 30 to 60 minuites after loading the antigen. These findings indicate that this method may be useful in the diagnosis of allergic gastroenteropathy.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-15581051-21993アレルギー性胃腸症の病態に関する研究 第2編 ハウスダストに起因するアレルギー性胃腸症の存在に関する検討97106ENYujiToyotaNot only many food substances but also other substances such as house dust(HD) may serve as causative allergens of allergic gastroenteropathy. To clarify the causative allergens and the pathogenesis of allergic gastroenteropathy, an oral loading test using HD, was applied to two patients with allergic gastroenteropathy caused by an unknown antigen, and with HD-sensitivity, and 24 bronchial asthmatics with or without HD-sensitivity, ther were examined using the ultrasonography of stomach reported previously. Two patients with gastroenteropathy showed a positive skin test and IgE RAST to HD, although they had bronchial asthma in the past history. Peripheral blood eosinophils in the 1st and 2nd patients showed a high (max 78%) and slightly increased (9%) value. The precipitating antibody in the two cases was negative, but lymphocyte blastogenesis to HD was enhanced in one case. During the oral loading test using HD, both patients had abdominal pain at immediate and late phase and acceleration of gastric peristalic movements was confirmed by ultrasonography. One of the 2 patients showed a strong gastrointestinal reaction during the delayed phase. LTC4 and histamine were considered to be involved in the abdominal pain of these cases. One of the 12 patients with bronchial asthma and HD-sensitivity showed an immediate reaction in oral loading test without abdominal pain, suggensting a correlation of the hypersensitivity between the bronchi and the digestive tract, including 2 former cases.No potential conflict of interest relevant to this article was reported.