Neumann T G, Craig R M, Poticha S
Am J Clin Nutr. 1978 Nov;31(11):1993-7. doi: 10.1093/ajcn/31.11.1993.
A patient is presented who developed a granulomatous hepatitis and pleuritis approximately 7 months after an ileal bypass procedure for morbid obesity. Although the etiological agent was presumed to be Mycobacterium tuberculosis no pathogenic organism was grown from the liver, pleura, bone marrow, sputum, or gastric aspirate. The possibly increased susceptibility of these patients to mycobacterial infections is discussed. The value of obtaining serum levels of ethambutol, isoniazid, and rifampin, in patients with malabsorption is stressed. Although this patient seemed to respond to antituberculous therapy, other possible causes for the granulomatous process are explored.
本文报告了一例患者，该患者在接受病态肥胖回肠旁路手术后约7个月出现肉芽肿性肝炎和胸膜炎。尽管病因推测为结核分枝杆菌，但在肝脏、胸膜、骨髓、痰液或胃吸出物中均未培养出致病生物体。讨论了这些患者可能增加的对分枝杆菌感染的易感性。强调了在吸收不良患者中检测血清乙胺丁醇、异烟肼和利福平水平的价值。尽管该患者似乎对抗结核治疗有反应，但仍探讨了肉芽肿形成过程的其他可能原因。
