Departments of Pediatrics, Division of Nephrology, Taipei Veterans General Hospital, Taiwan, ROC.
J Chin Med Assoc. 2011 Jul;74(7):322-4. doi: 10.1016/j.jcma.2011.05.009. Epub 2011 Jul 7.
Eosinophilic peritonitis is an uncommon clinical entity with diagnostic considerations separate from those of tuberculous peritonitis. We report a patient on continuous ambulatory peritoneal dialysis (CAPD) with eosinophilic peritonitis resulting from tuberculous peritonitis. Acid-fast stain and mycobacterial culture of peritoneal dialysis effluent were both negative result. In the peritoneal dialysis effluent and blood samples, Mycobacterium tuberculosis was detected by polymerase chain reaction analyses. The initiation of antituberculous therapy resulted in resolution of the eosionphilia in the dialysis effluent. After 14 days of antituberculous therapy, the polymerase chain reaction analyses of tuberculosis were negative for both the blood and peritoneal dialysis effluents. Evaluation of tuberculosis infection is necessary if the CAPD-related peritonitis presents with an unusual and unexplained clinical course. Polymerase chain reaction can play an important role in the diagnosis of tuberculous peritonitis in patients undergoing CAPD.
嗜酸性粒细胞性腹膜炎是一种罕见的临床病症,其诊断要点与结核性腹膜炎不同。我们报告了一例在持续不卧床腹膜透析(CAPD)治疗的患者,并发由结核性腹膜炎引起的嗜酸性粒细胞性腹膜炎。腹透液的抗酸染色和分枝杆菌培养均为阴性结果。通过聚合酶链反应分析在腹透液和血液样本中检测到结核分枝杆菌。抗结核治疗的开始导致透析液中的嗜酸性粒细胞增多得到缓解。抗结核治疗 14 天后,血液和腹透液的聚合酶链反应分析均为结核阴性。如果 CAPD 相关性腹膜炎表现出异常且原因不明的临床过程,则需要评估结核感染。聚合酶链反应在诊断接受 CAPD 治疗的结核性腹膜炎患者中具有重要作用。