Fukasawa H, Suzuki H, Kato A, Yamamoto T, Fujigaki Y, Yonemura K, Hishida A
First Department of Medicine, Hamamatsu University School of Medicine, Japan.
Am J Med Sci. 2001 Dec;322(6):373-5. doi: 10.1097/00000441-200112000-00012.
Hemodialysis patients are known to develop the complication of extrapulmonary tuberculosis more frequently than the general population. Tuberculous arthritis is a rare form of extrapulmonary tuberculosis and is reported to occur in approximately 1% of cases in nonuremic patients. Only 3 cases in dialysis patients, who were not proven by a bacterial culture or had died before treatment, have been reported. We report herein a culture-proven case of tuberculous arthritis developing at the sternoclavicular joint, which initially mimicked an apparent neoplasm in a hemodialysis patient. A favorable outcome was obtained after antituberculous therapy. Tuberculosis must be considered one of the most significant diagnoses in hemodialysis patients who present with a tumor-like lesion.
已知血液透析患者比普通人群更易发生肺外结核并发症。结核性关节炎是肺外结核的一种罕见形式，据报道在非尿毒症患者中约1%的病例会发生。血液透析患者中仅有3例未通过细菌培养证实或在治疗前死亡的病例被报道。我们在此报告1例经培养证实的、发生于胸锁关节的结核性关节炎病例，该病例最初在1例血液透析患者中表现类似明显的肿瘤。抗结核治疗后取得了良好效果。对于出现肿瘤样病变的血液透析患者，必须将结核病视为最重要的诊断之一。
