Rafiei Nastaran, Khanlou Negar, Khosa Shaweta, Moheb Negar, Mishra Shri K
Neurology, David Geffen School of Medicine at University of California, Los Angeles, USA.
Pathology, David Geffen School of Medicine at University of California, Los Angeles, USA.
Cureus. 2018 Dec 7;10(12):e3703. doi: 10.7759/cureus.3703.
Tuberculous granulomatous vasculitis is commonly associated with meningitis and retinitis. We describe a 39-year-old male, with a history of pulmonary tuberculosis (TB) who presented with progressive weakness, pain, tingling and numbness in the bilateral lower extremities. Significant atrophy and weakness of the lower extremities were evident along with absent reflexes. Nerve conduction studies and electromyography showed severe axonal polyneuropathy and denervation on the lower extremities. Nerve biopsy demonstrated small vessel leukocytoclastic vasculitis without any granuloma formation. Muscle biopsy was consistent with denervation and atrophy with target fiber changes. Tuberculosis-related vasculitis causing peripheral neuropathy is extremely rare and our case is unique in manifesting this presentation.
结核性肉芽肿性血管炎常与脑膜炎和视网膜炎相关。我们报告一名39岁男性，有肺结核病史，表现为双下肢进行性无力、疼痛、刺痛和麻木。下肢明显萎缩和无力，且反射消失。神经传导研究和肌电图显示双下肢严重轴索性多发性神经病和失神经支配。神经活检显示小血管白细胞破碎性血管炎，无任何肉芽肿形成。肌肉活检符合失神经支配和萎缩伴靶纤维改变。由结核相关血管炎导致的周围神经病变极为罕见，我们的病例在临床表现上独具特色。
