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[一例结核性淋巴结炎患者结核菌素皮内反应阴性的解读]

[The interpretation of a negative intradermal reaction to tuberculin in a case of tuberculous lymphadenitis].

作者信息

Tucciarone L, Papandrea S, Anaclerio S, Matrunola M, Bosco S

机构信息

I Istituto di Clinica Pediatrica, Università degli Studi di Roma La Sapienza.

出版信息

Minerva Pediatr. 1996 Jan-Feb;48(1-2):49-53.

PMID:9072664
Abstract

This work aims at describing a particular case of tuberculous lymphadenitis with negative tuberculin skin test in a five-year child who has afterwards developed Hodgkin disease. BK presence is initially demonstrated through the examination of a first bioptic sample of a lymph-node, then confirmed by the presence in the serum of mycobacterial antigens on the peripheral lymphocytes and monocytes. Nine months later the second bioptic sample puts in evidence the presence of Reed-Sternberg cells. The follow-up of our patient took place at the Pediatric Department of the University of Rome "La Sapienza" and lasted an overall period of twenty days. The child was hospitalized twice and underwent a large number of radiological and laboratory tests. The therapy consisted only of medical specific treatment. Our study results lead us to evaluate the presence of immunological suppressive mechanisms in some particular tuberculosis cases, justifying the tuberculin skin-test negativity. When Hodgkin's disease has turned up, it has been too difficult to outline a precise temporal sequence of events, we could only advance hypothesis.

摘要

这项工作旨在描述一名5岁儿童患结核菌素皮肤试验阴性的结核性淋巴结炎的特殊病例,该儿童随后发展为霍奇金病。BK最初通过对淋巴结的首次活检样本检查得以证实,随后通过外周淋巴细胞和单核细胞的血清中存在分枝杆菌抗原得到确认。9个月后,第二次活检样本证实了里德-施特恩伯格细胞的存在。我们的患者在罗马“萨皮恩扎”大学儿科进行了随访,整个过程持续了20天。该儿童住院两次,接受了大量的放射学和实验室检查。治疗仅包括针对性的药物治疗。我们的研究结果使我们评估在某些特殊结核病例中存在免疫抑制机制,这解释了结核菌素皮肤试验阴性的原因。当霍奇金病出现时,很难勾勒出精确的事件时间顺序,我们只能提出假设。

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