透析患者の結核症 : 第6報 粟粒結核症の特性
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概要
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Dialysis patients showed a high susceptibility to miliary tuberculosis and if once affected, the fatality was high. In order to clarify the characteristics of miliary tuberculosis in dialysis patients, a statistical study was done.<BR>The subjects were 7274 dialysis patients in 161 institutions including 150 cases complicated with tuberculosis. Among them 9 males and 6 females were miliary tuberculosis. They were between 30 to 69 years of age. Seven males and six females died of it.<BR>As to the causative diseases for renal failure, pyelonephritis and polycystic kidney were seen more frequently among the patients with milialy tuberculosis than among all tuberculosis patients receiving dialysis.<BR>The attack rate of miliary tuberlcuosis showed a rise from 3 months prior to the initiation of dialysis therapy, and it was highest during the initial 3 months of dialysis therapy, then it went down gradually, although it remained much higher during dialysis therapy than that of the general population.<BR>Lung was involved most frequently, next liver and spleen, then followed by bone-joint, lymphnode, kidney and urinary tract, pancreas, pleura, gut, bone marrow, peritoneum, trachea, adrenal, meninges and pericardium. Almost all organs except muscle, brain and thyroid were involved.<BR>Fever was the most common one among the symptoms and signs which lead to the diagnosis, then followed by anorexia, weakness, fatigue, weightloss, cough, abdominal pain, etc. Chest X-ray was useful for diagnosis in 6 cases among 11 patients. Tubercle bacilli were detected in 3 cases. Autopsy was perfomed in 11 cases. Among them 7 cases were proved to be miliary tuberculosis at autopsy.<BR>Seven patients had 8 episodes of tuberculosis in total. They occurred 22. 1 years ago in average.<BR>The present study demonstrated the characteristics of miliary tuberculosis among dialysis patients.
- 日本結核病学会の論文
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