Pateron D, Naveau S, Brivet F, Bedossa P, Poynard T, Chaput J C
Service d'Hépato-Gastroentérologie, Hôpital Antoine-Béclère, Clamart.
Gastroenterol Clin Biol. 1990;14(1):80-3.
The authors report a case of tuberculous pancreatitis in a 29 year old Zairan man. Serum antibodies against HIV were positive. T-lymphocyte analysis revealed 18/mm3 OKT4 with an OKT4/OKT8 ratio of 0.43. The initial examination suggested severe acute pancreatitis. Only the postmortem histopathological analysis revealed tuberculous pancreatitis, showing several miliary lesions with caseous necrosis and acid fast bacili (Ziehl stain). Subsequently, cultures (sputum, bronchoalveolar lavage, pleural effusion, ascitis) of bacili identified Mycobacterium tuberculosis. Tuberculous pancreatitis should be considered in subjects with acute pancreatitis according to the epidemiological context, once the most frequent causes of pancreatitis have been eliminated.
作者报告了一例29岁扎伊尔男性患结核性胰腺炎的病例。抗HIV血清抗体呈阳性。T淋巴细胞分析显示OKT4为18/mm³，OKT4/OKT8比值为0.43。初步检查提示为重症急性胰腺炎。仅尸检组织病理学分析显示为结核性胰腺炎，可见多个粟粒样病变伴干酪样坏死及抗酸杆菌（齐-尼氏染色）。随后，对杆菌进行培养（痰液、支气管肺泡灌洗、胸腔积液、腹水），鉴定为结核分枝杆菌。根据流行病学背景，一旦排除了胰腺炎最常见的病因，对于患有急性胰腺炎的患者应考虑结核性胰腺炎。
