透析患者の結核症 : 第2報 罹患臓器の特性

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概要

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• As we have reported, extrapulmonary organs are frequently involved in tuberculosis developed among dialysis patients. A study was undertaken to assess the characteristics of such organs.<BR>The study subjects were 7274 dialysis patients including 150 tuberculosis patients treated in 161 institutions in Japan. Among them, the involved sites of tuberculosis were documented in 137 patients. Almost all organs were involved by tuberculosis in different frequency with various combinations, except muscle and brain. Patients were less fatal when tuberculosis was found in frequently involved organs. On the contrary, patients showed high fatality when tuberculosis was found in less frequently involved organs. Thus, the frequency of involvement of each organ was almost inversely proportional to the fatality rate of cases in which the respective organ was involved. The fatality of patients correlated to the number of organs involved. There were 2 groups of organs according to their frequency of involvement; the first group was less frequently involved organs such as liver, spleen, pancreas, bone marrow, pericardium, trachea and thyroid gland, and the second group was frequently involved organs such as lung, lymphnodes, kidney and urinary tract and pleura. The former was rarely involved in the past episode of tuberculosis. The fatality was high and relatively large number of organs were involved simultaeneously when the former was involved. The fatality was low and the small number of organs were involved simultaeneously when the latter was involved. The latter organs were frequently involved in the past episode of tuberculosis and tuberculosis of the latter was also commonly seen in the general population. Tubercuosis patients receiving dialysis frequently had past history of tuberculosis. Organs involved in the past episode were again very often involved in the present tuberculosis. These facts indicate that the relapse takes place frequently in tuberculosis of dialysis patients.

• 日本結核病学会の論文

著者

• 稲本 元

  慶応義塾大学医学部附属病院 中央透析室

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