Celik Aykut Ferhat, Altiparmak Mehmet Riza, Pamuk Gülsüm Emel, Pamuk Omer Nuri, Tabak Fehmi
Department of Nephrology, Cerrahpaşa Medical Faculty, University of Istanbul, Rasimpaşa Mah, Taşlibayir Sok, No: 14 Daire: 10, Kadikoy-Istanbul, Turkey.
Yonsei Med J. 2005 Dec 31;46(6):847-50. doi: 10.3349/ymj.2005.46.6.847.
This paper describes the first case of common variable immunodeficiency (CVID) and AA amyloidosis. A recently treated tuberculosis, and chronic inflammation induced by frequent respiratory tract infections, were thought to be responsible for the amyloidosis. No other reason for this condition could be detected. Although T cell dysfunction in some CVID patients has been reported, pulmonary tuberculosis is quite rare with this condition. Bacterial or viral agents or evidence in favour of intestinal tuberculosis, which would explain this patient's recurrent diarrhea, were not found. In this case, the response of the attacks of diarrhea to metranidazole and the histologic observation of extensive intestinal amyloid deposition, which is known to decrease intestinal motility, made us conclude that the diarrhea was associated with bacterial overgrowth. In this report, we discuss the association of CVID and tuberculosis to secondary amyloidosis and recurrent diarrhea.
本文描述了首例常见可变免疫缺陷(CVID)合并AA型淀粉样变性病的病例。近期治愈的结核病以及频繁呼吸道感染引发的慢性炎症被认为是导致淀粉样变性病的原因。未检测到导致该病症的其他原因。尽管有报道称部分CVID患者存在T细胞功能障碍,但合并肺结核在该病症中相当罕见。未发现支持肠道结核的细菌或病毒病原体或证据,而肠道结核本可解释该患者反复腹泻的症状。在该病例中,腹泻发作对甲硝唑的反应以及广泛肠道淀粉样沉积的组织学观察(已知该沉积会降低肠道蠕动)使我们得出结论,腹泻与细菌过度生长有关。在本报告中,我们讨论了CVID与结核病关联导致继发性淀粉样变性病及反复腹泻的情况。