{"created":"2023-06-20T15:49:21.399464+00:00","id":3944,"links":{},"metadata":{"_buckets":{"deposit":"b9c6e8ef-b09a-404b-8f69-59d8856eb52d"},"_deposit":{"created_by":4,"id":"3944","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"3944"},"status":"published"},"_oai":{"id":"oai:hama-med.repo.nii.ac.jp:00003944","sets":["1:75:81"]},"author_link":["12023","12024","12025","12026","12027","12028","12029"],"control_number":"3944","item_3_biblio_info_5":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2022-03-15","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"23","bibliographicPageStart":"18","bibliographicVolumeNumber":"2","bibliographic_titles":[{"bibliographic_title":"浜松医科大学小児科学雑誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"Hamamatsu Journal of Pediatrics","bibliographic_titleLang":"en"}]}]},"item_3_description_9":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"蛋白漏出性胃腸症の原因疾患は感染性腸炎や食物蛋白誘発胃腸炎（FPIES）等様々な疾患がある．FPIESは発熱やCRP上昇を認めることもあり，感染性腸炎と区別がつかない場合もある．今回，その鑑別に注意を要した症例を報告する．\n症例は5か月男児で，入院25日前から離乳食を開始し，15日前から嘔吐，下痢を繰り返し入院した．入院時に浮腫，低アルブミン血症，CRP高値があった．入院3日目に発熱し，血液・便培養で検出された黄色ブドウ球菌が原因と考え，抗菌薬を投与したところ，低アルブミン血症も改善した．そのため，当初は感染性腸炎が原因の蛋白漏出性胃腸症と考えた．しかし，入院15日前から症状が出現していて進行が遅いこと，離乳食開始と発症時期からFPIESの可能性を考え食物負荷試験（OFC）を行った．結果，米負荷で嘔吐，発熱，下痢，CRP4.2 mg/dlと上昇し陽性と判定した．よって，米によるFPIES が原因の蛋白漏出性胃腸症の診断に至った．なお，関連は不明であるが，自己免疫性好中球減少症を合併し，CRPが0.17-0.59 mg/dLと推移し，他の食物負荷試験時に判定に苦慮した．\n本症例は，当初メチシリン耐性黄色ブドウ球菌（MRSA）腸炎による蛋白漏出性胃腸症と考えられたが，OFCによりFPIESが証明された．消化管感染症が証明されても，蛋白漏出性胃腸症の原因疾患としてFPIESを鑑別する必要がある．","subitem_description_language":"ja","subitem_description_type":"Abstract"}]},"item_3_publisher_6":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"浜松医科大学小児科学雑誌編集部","subitem_publisher_language":"ja"}]},"item_3_relation_27":{"attribute_name":"医中誌論文ID","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"2022168183","subitem_relation_type_select":"ICHUSHI"}}]},"item_3_source_id_20":{"attribute_name":"EISSN","attribute_value_mlt":[{"subitem_source_identifier":"2436-2433","subitem_source_identifier_type":"EISSN"}]},"item_3_version_type_32":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_access_right":{"attribute_name":"アクセス権","attribute_value_mlt":[{"subitem_access_right":"open 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Ryuhei","creatorNameLang":"en"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"夏目, 統","creatorNameLang":"ja"},{"creatorName":"NATSUME, Osamu","creatorNameLang":"en"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2022-03-15"}],"displaytype":"detail","filename":"hjop_2_1_18.pdf","filesize":[{"value":"742.6 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"hjop_2_1_18","objectType":"fulltext","url":"https://hama-med.repo.nii.ac.jp/record/3944/files/hjop_2_1_18.pdf"},"version_id":"85817444-9f28-4831-8981-4c239fb5f5a0"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"食物蛋白誘発胃腸炎","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"消化管アレルギー","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"米","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"蛋白漏出性胃腸症","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"自己免疫性好中球減少症","subitem_subject_language":"ja","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal 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