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Article in Japanese
Abstract
Case Report
A case of miliary tuberculosis accompanied with jaundice successfully treated by antituberculosis drugs with corticosteroid
Akari Kondoa Hiroyuki Matsudaa Kazuo Tsuchiyaa Mitsuru Niwaa Takeo Hirataa Takafumi Sudab
aDepartment of Respiratory Medicine, Shizuoka City Shizuoka Hospital
bSecond Department of Internal Medicine, Hamamatsu University School of Medicine
ABSTRACT
A 73-year-old-woman was admitted to our hospital because of disturbance of consciousness and loss of appetite. Chest X-ray films and CT scan images showed numerous nodules in both lung fields. A specimen of bone marrow aspiration revealed small epithelioid granulomas, and Mycobacterium tuberculosis was finally cultured by sputum and urine. She was given a diagnosis of miliary tuberculosis and received antituberculosis drugs. The liver dysfunction existed on admission; however, it gradually deteriorated, and she presented jaundice despite the administration of antituberculosis drugs. Plasma exchange was initiated, and corticosteroids were added to the antituberculosis drugs. As a result of treatments, the liver dysfunction recovered. After reducing the dose of corticosteroids, liver function again worsened. We performed liver biopsy, and the liver specimens showed epithelioid granulomas. We considered that the liver dysfunction was caused by liver tuberculosis.
KEYWORDS
Miliary tuberculosis Jaundice Hepatic tuberculosis Steroid
Received 14 Jan 2014 ／ Accepted 17 Mar 2014
AJRS, 3(4): 590-593, 2014
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