Malacoplakia in a teenager: A case report

Authors

DOI:

https://doi.org/10.22516/25007440.475

Keywords:

Malacoplakia, Gastrointestinal tract, Colon

Abstract

Malacoplakia is a rare, granulomatous, chronic inflammatory disease characterized by foamy histiocytic infiltrations known as Michaelis-Gutmann inclusions. The urinary system is the most commonly affected site, followed by the gastrointestinal tract. The prognosis of the disease depends on the extent, location, and underlying health status of the patient. This is the clinical case of a 15-year-old male patient with no significant health history. At age 7, the patient presented with hematochezia and mild abdominal pain that improved after defecation. A colonoscopy was performed, finding pseudopolypoid lesions in the sigmoid colon. Biopsy samples were taken, and the report showed inflammatory polyps with exacerbation foci, numerous histiocytes (Michaelis-Gutmann bodies), and reactive epithelial changes that lead to diagnose malacoplakia. Conclusion: Malacoplakia is a very rare disease in young people with no underlying disease. Its prevalence is unknown, but more than 700 cases have been reported. It can occur at all ages, with a mean age at diagnosis of 50 years. Pediatric cases are rare. There is a higher incidence in men, and it has no racial predilection. Between 60 % and 80 % of cases involve the urinary tract (bladder, kidneys, and urethra); 15 % involve the digestive tract (left colon, sigmoid colon, rectum, and stomach); and, to a lesser extent, other areas such as skin, lungs, and central nervous system may be affected. The prognosis of the disease is usually good. This is the case of a healthy 15-year-old male with no apparent associated disease that illustrates the rarity of this presentation and the need for a high level of clinical suspicion to diagnose the disease.

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Author Biographies

Ruben Gustavo Muñoz Cedeño, Hospital de Especialidades Dr. Abel Gilbert Pontón

Médico Posgradista de Gastroenterología, Hospital de Especialidades Dr. Abel Gilbert Pontón, Universidad de Guayaquil, Ecuador. 

Gema Nathalye Rodríguez Chica, Hospital Universitario de Guayaquil

Magister en Seguridad y Salud Ocupacional, Universidad Espíritu Santo. Médico Residente de la Unidad de Cuidados Intensivos Maternos, Hospital Universitario, Universidad de Guayaquil, Guayaquil, Ecuador. 

Priscila Elizabeth Martínez Ballesteros, Hospital de Especialidades Dr. Abel Gilbert Pontón

Médico especialista en Gastroenterología, Universidad de La Habana, Cuba; Coordinadora del Posgrado de Gastroenterología, Universidad de Guayaquil; Formación en Ecoendoscopía en La Plata, Argentina.  Líder del servicio de Gastroenterología del Hospital de Especialidades Dr. Abel Gilbert Pontón, Guayaquil, Ecuador. 

Viviana Paullan Sani, Hospital de Especialidades Dr. Abel Gilbert Pontón

Médico especialista en Gastroenterología, Universidad de La Habana, Cuba. Tutora del posgrado de Gastroenterología, Hospital de Especialidades Dr. Abel Gilbert Pontón; Universidad de Guayaquil, Ecuador.

Fabricio Vera Zapata, Hospital General de Guayaquil los Ceibos (IESS)

Médico Gastroenterólogo, Hospital General de Guayaquil los Ceibos,  Tutor del Posgrado de Gastroenterología,  Universidad de Guayaquil;  Guayaquil, Ecuador.

 

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Figura 1. Videocolonoscopia en la que se observa la mucosa del colon sigmoide y recto con formaciones nodulares pseudopolipoidea

Published

2021-03-08

How to Cite

Muñoz Cedeño, R. . G., Rodríguez Chica, G. N., Martínez Ballesteros, P. E., Paullan Sani, V., & Vera Zapata, F. (2021). Malacoplakia in a teenager: A case report. Revista Colombiana De Gastroenterología, 36(1), 103–108. https://doi.org/10.22516/25007440.475

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Case report

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