Kobayashi Takehiko, Tsuyuguchi Kazunari, Kasai Takahiko, Suzuki Katsuhiro
Department of Internal Medicine, National Hospital Organization, Kinki-Chuo Chest Medical Center, Japan.
Department of Infectious Diseases, National Hospital Organization, Kinki-Chuo Chest Medical Center, Japan.
Intern Med. 2018 Nov 15;57(22):3285-3288. doi: 10.2169/internalmedicine.0207-17. Epub 2018 Jul 6.
Tuberculosis may be accompanied by various hematological abnormalities during treatment, and occasionally thrombocytopenia is also noted. Most cases of thrombocytopenia in tuberculosis are moderate, and there are few reports about thrombocytopenia with diffuse alveolar hemorrhaging (DAH) in pulmonary tuberculosis. We describe the case of an 82-year-old man with pulmonary tuberculosis and tuberculous pleurisy. He underwent anti-tuberculosis chemotherapy; during tuberculosis treatment, he experienced DAH due to fulminant thrombocytopenia. Thrombocytopenia is a common finding in patients with pulmonary tuberculosis, but the laboratory findings should be carefully evaluated. Thrombocytopenia during anti-tuberculosis chemotherapy can cause life-threatening DAH.
结核病在治疗过程中可能伴有各种血液学异常，偶尔也会出现血小板减少。结核病患者的血小板减少多数为中度，关于肺结核伴弥漫性肺泡出血（DAH）的血小板减少报道较少。我们描述了一名82岁患有肺结核和结核性胸膜炎男性患者的病例。他接受了抗结核化疗；在结核病治疗期间，由于暴发性血小板减少而出现DAH。血小板减少在肺结核患者中很常见，但实验室检查结果应仔细评估。抗结核化疗期间的血小板减少可导致危及生命的DAH。
