Biggar W D, Crawford L, Cardella C, Bear R A, Gladman D, Reynolds W J
Am J Pathol. 1985 Apr;119(1):5-11.
Malakoplakia is a chronic granulomatous inflammatory disorder. It is suspected clinically by the presence of chronic infection and diagnosed by histologic examination of affected tissues. Studies of 4 patients with malakoplakia--2 renal transplant recipients, 1 patient with systemic lupus erythematosus, and 1 patient with polymyositis--are reported. All patients were receiving prednisone and azathioprine at the time of diagnosis and had an infection caused by Escherichia coli. Leukocytes from all patients failed to kill Staphylococcus aureus and E coli normally in vitro. Cholinergic agonists had no apparent effect on bacterial killing in vitro or in vivo in the 2 patients examined. Clinically, malakoplakia improved significantly when immunosuppressive therapy was tapered or discontinued, and leukocyte function returned to normal in all 4 patients. The cases reported here and those documented previously suggest that the pathogenesis of malakoplakia and its treatment may not be the same for all patients. Malakoplakia may be more common than previously thought, particularly with the increased use of immunosuppressive therapy.
软斑病是一种慢性肉芽肿性炎症性疾病。临床上根据慢性感染的存在怀疑该病，并通过对受累组织进行组织学检查来确诊。本文报告了4例软斑病患者的研究情况，其中2例为肾移植受者，1例为系统性红斑狼疮患者，1例为多发性肌炎患者。所有患者在诊断时均接受泼尼松和硫唑嘌呤治疗，且均感染了大肠杆菌。所有患者的白细胞在体外均不能正常杀灭金黄色葡萄球菌和大肠杆菌。在所检查的2例患者中，胆碱能激动剂在体外和体内对细菌杀灭均无明显作用。临床上，当免疫抑制治疗逐渐减量或停止时，软斑病明显改善，且所有4例患者的白细胞功能均恢复正常。此处报告的病例及先前记录的病例表明，软斑病的发病机制及其治疗方法可能并非适用于所有患者。软斑病可能比以前认为的更为常见，尤其是随着免疫抑制治疗的使用增加。
