乳幼児エピツベルクローシスの病因についての再評価

  • 近藤 信哉
    東京都立清瀬小児病院呼吸器科 東京都保健医療公社多摩北 部医療センタ一小児科
  • 宮川 知士
    東京都立清瀬小児病院呼吸器科
  • 伊藤 真樹
    東京都立清瀬小児病院呼吸器科

書誌事項

タイトル別名
  • REEVALUATION ON PATHOGENESIS OF EPITUBERCULOSIS IN INFANTS AND CHILDREN WITH TUBERCULOSIS
  • ニュウヨウジ エピツベルクローシス ノ ビョウイン ニ ツイテ ノ サイヒョウカ

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抄録

[Object] We try to reevaluate the pathogenesis of epituberculosis in infants and children with tuberculosis, because most studies on epituberculosis were done more than 50 years ago.<BR>[Subje ct and methods] Nineteen children (less than 1 y /o: 12, 1 y/o: 2, 2 y/o: 3, and 4 y/o: 2) were studied by CT imaging and bronchofiberscopy in addition to gastric Mycobacterium tuberculosis examination and regular chest XP.<BR>[Results] In 13 of total 19 patients (68%), lobar or segmental epituberculosis occured after starting antituberculous chemotherapy, including a case in which epituberculosis of right upper lobe was recognized at the time of diagnosis of tuberculosis and after starting chemotherapy, epituberculosis of right middle lobe was observed. CT imaging revealed that all 19 patients had enlargement of mediastinal and/or hilar lymphonodes compressing neighboring bronchi, and 16 of total 19 patients (84%) demonstrated relevant parenchymal infiltration. Gastric Mycobacterium tuberculosis was positive in 15 out of 19 patients (79%). Bronchofiberscopy was done in 16 patients, and it demonstrated mass lesion of various size on the bronchial wall in 13 patients (81%).<BR>[Conclusion] The present study d emonstrated that epituberculosis predominantly occured in tuberculosis infants less than one year old, which was different from the previous reports. The CT imaging also makes clear that epituberculosis may be the atelectasis of lobe or segment which occurs mostly due to compression of bronchi by the enlargement of mediastinal and/or hilar lymphonodes and their early exacerbation after starting chemotherapy. Bronchofiberscopy also elucidated that bronchial wall mass lesion resulted from perforation of lynphonodes may partially contribute to the formation of epituberculosis.

収録刊行物

  • 結核

    結核 82 (7), 569-575, 2007

    一般社団法人 日本結核病学会

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