初级上腺功能缺陷急性渐进性系统性炎症伴随着潜伏性结核病:一个病例报告
Kasumi Nishikawa1, Mizuki Nitta2, Shoma Tanaka2
1Family Medicine, Shimane University Hospital, Izumo, JPN.
Cureus
|December 13, 2023
概括
这一案例凸显了潜在的结核病作为上腺功能不全的潜在原因. 埃索诺菲利亚表明与阿托皮性疾病的联系,强调对一般症状进行全面评估.
科学领域:
- 内分泌学 在内分泌学.
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 上腺功能不足 (AI) 经常与自身免疫性疾病有关.
- 感染性病因,如结核病 (TB),也可能导致AI.
- 像不适和这样的非特异性症状需要彻底的诊断工作.
研究的目的:
- 呈现一种可能与潜在结核病相关的初级上腺功能缺陷病例.
- 探索AI,潜伏性结核病和eosinophilia之间的关联.
- 强调在AI诊断中考虑感染原因和过敏状况的重要性.
主要方法:
- 诊断评估包括早晨皮质醇和上腺皮质激素 (ACTH) 水平.
- 磁共振成像 (MRI) 排除二级/三级AI原因.
- 干扰素释试验 (T-SPOT®) 用于潜伏结核病查.
- 用对比度增强的计算机断层扫描 (CT) 检查肺外结核病.
- 评估生和亚托皮性皮肤炎的情况.
主要成果:
- 通过荷尔蒙水平证实主要上腺功能不全.
- 阳性T-SPOT®表明潜伏结核病,没有活跃疾病迹象.
- 检测到埃索诺菲利亚,与亚托邦性皮肤炎相关.
- 肺外结核作为AI的原因在CT上仍未得到证实.
结论:
- 隐性结核病可能是上腺功能不充分的一个未被认可的原因.
- 乙素可能表明与上腺功能障碍同时存在的过敏或亚托皮性疾病.
- 包括结核病查在内的全面评估对于患有AI症状的患者至关重要.
- 需要保持警的监测,因为潜伏结核病可能会导致像AI这样的严重并发症.
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