Hou Chih-Lung, Tsai Yi-Chan, Chen Li-Chen, Huang Jing-Long
Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Clin Rheumatol. 2008 May;27(5):557-63. doi: 10.1007/s10067-007-0741-8. Epub 2007 Oct 17.
Systemic lupus erythematosus (SLE) patients had an increased susceptibility to tuberculosis (TB). The aim of this study was to investigate the prevalence and clinical characteristics of TB in SLE patients, with focus on the differences between pulmonary and extra-pulmonary TB. This is a retrospective study that reviewed the medical records of 3,179 SLE patients from 1985 to 2004. The diagnosis of TB was confirmed by one of the following: positive acid-fast bacillus (AFB) smear, positive culture of Mycobacterium tuberculosis from appropriate specimens, or a histopathologic finding of caseating granuloma on specimen. During the 20-year review period, TB was documented in 19 SLE patients, with 21 episodes. Ten of 21 episodes (47.6%) were pulmonary TB while the other 11 episodes (52.4%) were extra-pulmonary TB. Among extra-pulmonary TB, there were joint and cutaneous involvements in five, miliary in two, Pott's disease in two, peritoneum in one, and spleen in one. The most common manifestations of TB were fever and cough. Delayed diagnosis and adverse effects of anti-TB therapy were observed in the extra-pulmonary TB group. While SLE patients commonly present with prolonged fever or chronic cough, tuberculosis infection should be taken into consideration.
系统性红斑狼疮（SLE）患者患结核病（TB）的易感性增加。本研究的目的是调查SLE患者中结核病的患病率和临床特征，重点关注肺结核和肺外结核之间的差异。这是一项回顾性研究，回顾了1985年至2004年3179例SLE患者的病历。结核病的诊断通过以下之一得以证实：抗酸杆菌（AFB）涂片阳性、从适当标本中培养出结核分枝杆菌阳性，或标本上有干酪样肉芽肿的组织病理学发现。在20年的回顾期内，19例SLE患者记录有结核病，共21次发作。21次发作中有10次（47.6%）为肺结核，另外11次发作（52.4%）为肺外结核。在肺外结核中，关节和皮肤受累5例，粟粒性结核2例，脊柱结核2例，腹膜结核1例，脾结核1例。结核病最常见的表现是发热和咳嗽。在肺外结核组中观察到抗结核治疗的诊断延迟和不良反应。虽然SLE患者通常表现为长期发热或慢性咳嗽，但应考虑结核感染。
