Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongou, Bunkyo-ku, Tokyo, 113-8655, Japan.
Mod Rheumatol. 2013 Sep;23(5):1013-7. doi: 10.1007/s10165-012-0727-5. Epub 2012 Aug 1.
A 28-year-old rheumatoid arthritis woman treated with adalimumab was admitted with fever, cough, and right chest pain. X-ray showed right pleural effusion. By medical thoracoscopy, diffuse white nodules were observed, and biopsy specimen demonstrated epithelioid cell granulomas with necrosis and auramine-stained organisms, which suggested a diagnosis of tuberculous pleurisy. Medical thoracoscopy can be a potent diagnostic method when tuberculous pleurisy is suspected. Notably, despite latent tuberculosis treatment, active tuberculosis was not prevented.
一位 28 岁的类风湿关节炎女性正在接受阿达木单抗治疗，她因发热、咳嗽和右侧胸痛入院。X 光显示右侧胸腔积液。通过胸腔镜检查，观察到弥漫性白色小结节，活检标本显示伴有坏死和金胺染色病原体的上皮样细胞肉芽肿，提示结核性胸膜炎的诊断。当怀疑结核性胸膜炎时，胸腔镜检查可以是一种有效的诊断方法。值得注意的是，尽管进行了潜伏性结核病治疗，但仍未能预防活动性结核病。
