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[急性淋巴细胞白血病(ALL)患者的严重粟粒性肺结核尸检病例]

[An autopsy case of severe miliary tuberculosis in a patient with acute lymphatic leukemia (ALL)].

作者信息

Misonou J, Kikuchi Y, Aizawa M, Fukuhara T, Hirano T, Kobayashi M, Morioka M, Takemori N, Sakurada K, Miyazaki T

出版信息

Gan No Rinsho. 1987 Jun;33(6):703-13.

PMID:3474434
Abstract

A 58-year-old Japanese man being diagnosed as having ALL suffered from continuous fever and dysfunction of the liver and kidneys despite being in a state of haematological remission. Further clinical investigations, however had not been able to find the causes of his condition before his death. The autopsy revealed severe miliary tuberculosis affecting many organs including the heart, lungs, liver, spleen, kidneys, thyroid gland, pancreas, bone marrow, and central nervous system, which is compatible with multiple organ failures. Recent pharmacological advances have increased the usage of many kinds of antineoplastic drugs, and this has resulted in increased chances of opportunistic infections by various microorganisms in the course of treatment. The present case implies the significance of the reactivation of tuberculosis in the secondary immunodeficient syndrome (SIDS).

摘要

一名58岁的日本男性被诊断患有急性淋巴细胞白血病(ALL),尽管处于血液学缓解状态,但仍持续发热,伴有肝肾功能障碍。然而,在他去世前,进一步的临床检查未能找到其病情的病因。尸检显示严重的粟粒性肺结核累及多个器官,包括心脏、肺、肝脏、脾脏、肾脏、甲状腺、胰腺、骨髓和中枢神经系统,这与多器官功能衰竭相符。近期药理学的进展增加了多种抗肿瘤药物的使用,这导致在治疗过程中各种微生物引起机会性感染的几率增加。本病例提示了继发性免疫缺陷综合征(SIDS)中结核病再激活的重要性。

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