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克罗恩病和肠结核病:从各个角度提出挑战
Andreia Guimarães1,2, João Gama3, Luis Curvo-Semedo2,4
1General Surgery Department, Hospital and University Centre of Coimbra, Coimbra, Coimbra, Portugal andreiahguimaraes@gmail.com.
BMJ case reports
|December 11, 2023
概括
一名克罗恩氏病患者在开始服用阿达利姆巴药物后患上了传播性结核病 (TB). 肠道结核病叠加克罗恩病需要手术切除才能恢复.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 一名患有新诊断的克罗恩病 (CD) 的年轻女性接受了阿达利姆巴治疗.
- 在开始治疗之前,常规结核病 (TB) 查测试呈阴性结果.
研究的目的:
- 报告一个罕见的传播性结核病 (TB) 病例,该病例在患有克罗恩病 (CD) 的患者中呈现出严重症状.
- 要突出诊断挑战和管理的肠结核病 (结核病) 叠加的炎症性肠病 (IBD).
主要方法:
- 用诊断成像 (断层扫描) 和微生物学分析 (吐培养) 呈现临床病例.
- 切除的乳房细胞组织组织的组织病理学检查.
- 治疗包括开始抗结核病治疗和停止免疫抑制剂.
主要成果:
- 患者患有扩散性结核病,并出现多发性输液,肺炎,腹膜炎和骨盆.
- 唾液培养证实了 Mycobacterium 结核病.
- 组织病理学揭示了共存的CD和状结核病,确认肠道结核病叠加在CD上.
结论:
- 在患有炎症性肠道疾病的患者中,Adalimumab治疗可能会揭露或加剧潜在结核病.
- 在免疫功能低下的患者中,结核病的早期诊断和及时治疗至关重要.
- 对于克罗恩病患者的叠加性肠结核病引起的并发症,可能需要进行手术.
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