Fujimoto Naoki, Masuoka Hiroshi, Kosaka Hiroko, Ota Satoshi, Ito Masaaki, Nakano Takeshi
First Department of Internal Medicine, Mie University School of Medicine, Tsu.
Intern Med. 2003 Aug;42(8):756-60. doi: 10.2169/internalmedicine.42.756.
We describe here an extremely rare case of primary amyloidosis which presented moderate pleural effusion and high fever. A 71-year-old man was admitted to our hospital because of exertional dyspnea, fatigue and fever. A chest X-ray showed right-sided moderate pleural effusion. A thoracocentesis revealed an exudative pleural effusion. Cytology and cultures of the effusion were negative. External drainage failed to control the effusion. To determine the etiology of the effusion and fever, bronchoscopy was performed. Biopsies of the tracheal wall showed amyloid deposition. The pleural effusion might have been due to the inflammation and the disturbed lymphatic drainage caused by the amyloid deposition. Treatment with melphalan (6 mg) and prednisolone (35 mg) for 4 days every 6 weeks decreased the fever and alleviated his symptoms.
我们在此描述一例极为罕见的原发性淀粉样变性病例，该病例表现为中度胸腔积液和高热。一名71岁男性因劳力性呼吸困难、疲劳和发热入院。胸部X线显示右侧中度胸腔积液。胸腔穿刺术显示为渗出性胸腔积液。积液的细胞学检查和培养均为阴性。外部引流未能控制积液。为确定积液和发热的病因，进行了支气管镜检查。气管壁活检显示有淀粉样沉积。胸腔积液可能是由淀粉样沉积引起的炎症和淋巴管引流障碍所致。每6周使用美法仑（6毫克）和泼尼松龙（35毫克）治疗4天，可降低体温并缓解他的症状。
