Korean J Intern Med.  2013 Jul;28(4):475-480. 10.3904/kjim.2013.28.4.475.

Malakoplakia in a healthy young female patient

• Hyun KH
• Shin HD
• Kim DH

• KMID: 1503785
• DOI: http://doi.org/10.3904/kjim.2013.28.4.475

Abstract

Malakoplakia is a rare granulomatous disease that occurs commonly in the urinary tract and secondarily in the gastrointestinal tract. Most reported cases of malakoplakia are associated with immunosuppressive diseases or chronic prolonged illness. Here, we report a rare case of malakoplakia in a young healthy adolescent without any underlying disease. A 19-year-old female was referred to our hospital following the discovery of multiple rectal polyps with sigmoidoscopy. She had no specific past medical history but complained of recurrent abdominal pain and diarrhea for 3 months. A colonoscopy revealed diverse mucosal lesions including plaques, polyps, nodules, and mass-like lesions. Histological examination revealed a sheet of histiocytes with pathognomonic Michaelis-Gutmann bodies. We treated the patient with ciprofloxacin, the cholinergic agonist bethanechol, and a multivitamin for 6 months. A follow-up colonoscopy revealed that her condition was resolved with this course of treatment.

Keyword

Malakoplakia; Michaelis-Gutmann bodies; Diverse mucosal lesions

MeSH Terms

Anti-Bacterial Agents/therapeutic use
Bethanechol/therapeutic use
Biopsy
Ciprofloxacin/therapeutic use
*Colon/drug effects/pathology
*Colonic Diseases/diagnosis/therapy
Colonoscopy
Drug Therapy, Combination
Female
Humans
*Intestinal Mucosa/drug effects/pathology
*Malacoplakia/diagnosis/therapy
Muscarinic Agonists/therapeutic use
Treatment Outcome
Vitamins/therapeutic use
Young Adult
Anti-Bacterial Agents
Muscarinic Agonists
Vitamins
Bethanechol
Ciprofloxacin