使用结核感染T细胞检测（QuantiFERON-TB Gold）来确定特发性硬结性红斑的病因：一例病例报告。

Use of QuantiFERON-TB Gold to determine the aetiology of idiopathic erythema induratum: A case report.

作者信息

Brandon Alisa, Mufti Asfandyar, Sibbald R Garry

机构信息

Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

Toronto Regional Dermatology and Wound Healing Clinic, Mississauga, ON, Canada.

出版信息

SAGE Open Med Case Rep. 2018 Oct 10;6:2050313X18804076. doi: 10.1177/2050313X18804076. eCollection 2018.

DOI:10.1177/2050313X18804076

PMID:30345057

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6180361/

Abstract

Although rare, erythema induratum is the most common entity presenting as lobular panniculitis with vasculitis. It is usually caused by a hypersensitivity reaction to , although other aetiologies have been reported. We present a case of a 73-year-old male with multiple recurring tender erythematous nodules on the backs of both calves and shins. Prior to arrival in our clinic, the patient underwent a 9-month course of isoniazid with no improvement and subsequently received a diagnosis of idiopathic erythema induratum. We performed an interferon-gamma release assay QuantiFERON-TB Gold which was positive for infection. The patient was successfully treated with ethambutol 1.6 g for 1 month; pyrazinamide 2 g for 2 months; and isoniazid 300 mg, vitamin B6 25 mg, and rifampin 600 mg for 6 months. This case highlights the utility of using interferon-gamma release assay QuantiFERON-TB Gold and a multidrug regiment over isoniazid in erythema induratum.

摘要

硬结性红斑虽罕见，但却是表现为小叶性脂膜炎伴血管炎的最常见病症。它通常由对……的超敏反应引起，不过也有其他病因的报道。我们报告一例73岁男性患者，双侧小腿和胫部后侧有多个反复出现的压痛性红斑结节。在到我们诊所就诊之前，该患者接受了9个月的异烟肼治疗，病情无改善，随后被诊断为特发性硬结性红斑。我们进行了γ-干扰素释放试验（结核感染T细胞检测），结果显示感染呈阳性。该患者接受乙胺丁醇1.6克治疗1个月、吡嗪酰胺2克治疗2个月、异烟肼300毫克、维生素B6 25毫克和利福平600毫克治疗6个月后成功治愈。该病例凸显了在硬结性红斑中使用γ-干扰素释放试验（结核感染T细胞检测）和多药联合方案而非异烟肼的效用。