[Analysis of factors for the development of pulmonary tuberculosis in persons with collagenosis]

Recently, the annual reduction in the incidence rate of tuberculosis has slowed in Japan. One reason for this trend is believed to be due to an increase in the number of immunocompromised hosts. In our department, we discovered 10 cases of pulmonary tuberculosis among 962 cases of collagenosis, and have analyzed the factors for the development of pulmonary tuberculosis in these patients. A total of 29 patients wer involved in the study: 22 with systemic lupus erythematosus (SLE) (active disease, 10; inactive disease, 12) and having no pulmonary complications, and seven with pulmonary tuberculosis and no concomitant diseases. Our findings were as follows: 1. Seven of the 10 patients with pulmonary tuberculosis also suffered from SLE. 2. Nine of the 10 patients had been treated with a corticosteroid or immunosuppressant. 3. Serum CH50 and erythrocyte sedimentation rate (ESR) were valuable indicators for diagnosing pulmonary tuberculosis in the patients with SLE. 4. Patients with SLE and pulmonary tuberculosis tended to show lymphopenia in peripheral blood, which was further enhanced by prolonged use of steroids. 5. Miliary tuberculosis rather than pulmonary tuberculosis tended to develop in elderly patients, and required longer hospitalization.