粟粒結核に起因した血球どん食症候群の１例

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タイトル別名
  • A CASE OF HEMOPHAGOCYTIC SYNDROME ASSOCIATED WITH MILIARY TUBERCULOSIS
  • ゾクリュウ ケッカク ニ キイン シタ ケッキュウドンショク ショウコウグン ノ 1レイ

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We reported a case of a 76-year-female with hemophagocytic syndrome caused by miliary tuberculosis. The patients had complained high fever over 38.0°C and anorexia. Her chest X-ray and computed tomography revealed disseminated miliary shadows in both lung fields. Laboratory examinations revealed anemia, thrombocytopenia and liver dysfunction. Bonemarrow aspirate revealed tuberculous granulomas and tubercle bacilli by acid-fast stains, and hemophagocytosis by macrophages. We diagnosed as miliary tuberculosis and tuberculosis-associated hemophagocytic syndrome, and started antituberculous and steroid therapy. After these therapy, fever, laboratory examinations dramatically improved.<BR>In this case, serum IL-18, sICAM-1, sVCAM-1 were elevated. These cytokines and adhesion molecules were reported to elevate in both hemophagocytic syndrome and tuberculosis correlating with disease activity. We conclude that IL-18, sICAM-1, sVCAM-1 may play important roles in pathogenesis of tuberculosis associated hemophagocytic syndrome.

収録刊行物

  • 結核

    結核 78 (6), 443-448, 2003

    一般社団法人 日本結核病学会

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