Mihălţan F, Lupu A, Ungureanu D, Halic G, Badea C, Marcu C
Serviciul de hematologie, Spitalul Colţea.
Pneumologia. 2001 Jul-Sep;50(3):177-81.
Many reports have associated tuberculosis with haematological abnormalities. These reports suggest that severe pulmonary tuberculosis, if associated with reduced tissue cellular reaction, may cause blood discrasias. Anemia was present in 32 percent of patients. Leucopenia with neutropenia and lymphopenia was observed in 15 percent in patients with very severe clinical tuberculosis. Active tuberculosis was associated with significant reductions in absolute numbers of total T, T4 and B lymphocytes, but there were no significant differences in total T8 counts. T4 lymphopenia causes reversal of T4/T8 ratio. Also, many histopathologic diagnosis of panniculitis have been reported in tuberculosis patients--the incidence of panniculitis caused by tuberculosis was 8.2%. We present a case of secondary pulmonary tuberculosis with atypically Rx changes, associated with polyserositis and severe leucopenia, which debuted with a panniculitis.
许多报告都将肺结核与血液学异常联系起来。这些报告表明，严重的肺结核若伴有组织细胞反应减弱，可能会导致血液恶病质。32%的患者存在贫血。在临床症状非常严重的肺结核患者中，15%观察到白细胞减少伴中性粒细胞减少和淋巴细胞减少。活动性肺结核与总T细胞、T4细胞和B淋巴细胞的绝对数量显著减少有关，但T8细胞总数没有显著差异。T4淋巴细胞减少会导致T4/T8比值逆转。此外，已有许多关于肺结核患者脂肪炎组织病理学诊断的报道——由肺结核引起的脂肪炎发生率为8.2%。我们报告一例继发性肺结核，伴有非典型的影像学改变，合并多浆膜炎和严重白细胞减少，首发表现为脂肪炎。
