Abnormalities of gastric mucous membrane in patients with steroid-dependent intractable asthma

Recently, we experienced two asthmatic patients with advanced gastric cancer. The two patients had steroid-dependent intractable asthma (SDIA) who had been on administration of corticosteroids for more than 2 years. To determine the influence of pathophysiology of SDIA on stomach mucous lesion, gastroscopic examinations and immunological examinations were performed in eight patients with SDIA, compared with 25 patient with non-SDIA. In patients with SDIA, gastric cancer, its precursor condition and immunosuppressive state were observed. These results suggest that the immunosuppressive state in SDIA induced by the long-term administration of corticosteroids may lead to the risk of gastric cancer development.

最近,進行胃癌を合併した気管支喘息症例を2例経験した｡2症例ともにステロイド依存性重症難治性喘息(SDIA)症例であり,SDIAが胃悪性腫瘍に関与している可能性が考えられた｡今回,SDIA症例における胃粘膜病変の臨床像および背景因子を検討する目的で,8例のSDIA症例における胃内視鏡検査,末梢血液分画,免疫グロブリン定量を行い,非SDIA症例と比較検討を行った｡SDIA症例においては胃癌･前癌状態が認められたが,非SDIA例では認められなかった｡SDIA群において,末梢血白血球は有意に増加し,リンパ球分画･IgGは有意に減少していた｡これらの結果より,ステロイド依存性重症難治性気管 支喘息症例においては免疫状態が抑制され,胃悪性腫瘍が発生する危険性があるものと考えられた｡