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NLM AIDSLINE
[Disseminated extrapulmonary tuberculosis in idiopathic CD4-lymphocytopenia]
Neukirch B; Kremer GJ; Innere Abteilung des St.-Josef-Hospitals,
April 30, 1995
Dtsch Med Wochenschr. 1995 Jan 5;120(1-2):23-8. Unique Identifier :

A previously healthy, now 42-year-old man suddenly fell ill with bouts of septic fever up to 39.5 degrees C, sweats and weight loss without any demonstrable organ involvement. Physical examination on hospitalization 3 weeks after onset of the illness was unremarkable. Blood sedimentation rate at one hour was 123 mm. There was also a moderate increase in gamma-GT and alkaline phosphatase. Routine bacteriological and serological tests failed to discover a causative microorganism. After imaging tests had provided first indication of splenic and hepatic involvement, biopsies of these two organs demonstrated disseminated epithelioid granulomas and Langhans giant cells. Staining and culturing of pelvic crest biopsy tissue showed evidence of Mycobacterium tuberculosis, but there was no evidence of pulmonary involvement. In addition to four-drug tuberculostatic treatment the patient was given glucocorticoids for several weeks to control the fever bouts. Persistent CD4+ T-lymphocytopenia was demonstrated as the cause of the entirely extrapulmonary tuberculosis in this HIV-negative patient. This is an only recently described and so far unexplained syndrome.

gamma-Glutamyltransferase/BLOOD Adult Alkaline Phosphatase/BLOOD Antitubercular Agents/THERAPEUTIC USE Blood Sedimentation Case Report Drug Therapy, Combination English Abstract Fever/DRUG THERAPY Human Male Prednisolone/THERAPEUTIC USE T-Lymphocytopenia, Idiopathic CD4-Positive/*COMPLICATIONS Tuberculosis, Hepatic/DRUG THERAPY/*ETIOLOGY Tuberculosis, Splenic/DRUG THERAPY/*ETIOLOGY JOURNAL ARTICLE

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