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[使用肿瘤坏死因子-α拮抗剂后发生结核性胸膜炎:病例报告]

[Tuberculous pleurisy after tumour necrosis factor-alpha antagonist usage: case report].

作者信息

Akoğlu Sebahat, Babayiğit Cenk, Karazincir Sinem, Balci Ali, Hanta Ismail

机构信息

Department of Chest Diseases, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey.

出版信息

Tuberk Toraks. 2008;56(4):448-52.

Abstract

A thirty-six year old male patient presented with dyspnea, right-sided chest pain, night sweats and intermittent fever. He has a history of ankylosing spondylitis treated with tumour necrosis factor-alpha (TNF-alpha) antagonist (infliximab). Computed tomography of the chest showed mediastinal lymphadenopathy, right-sided pleural effusion, and atelectasis. The pleural fluid was exudative with lymphocyte dominance. Closed pleural biopsy was nondiagnostic. The adenosine deaminase level of the pleural fluid was 110 U/L. In light of these findings, the patient was diagnosed as tuberculous pleurisy and antituberculous treatment was given. After one month, pleural fluid was markedly reduced.

摘要

一名36岁男性患者出现呼吸困难、右侧胸痛、盗汗及间歇性发热。他有强直性脊柱炎病史,曾接受肿瘤坏死因子-α(TNF-α)拮抗剂(英夫利昔单抗)治疗。胸部计算机断层扫描显示纵隔淋巴结肿大、右侧胸腔积液和肺不张。胸腔积液为渗出液,以淋巴细胞为主。闭式胸膜活检未明确诊断。胸腔积液腺苷脱氨酶水平为110 U/L。根据这些发现,患者被诊断为结核性胸膜炎并给予抗结核治疗。1个月后,胸腔积液明显减少。

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