Document Detail


Miliary tuberculosis associated with chronic neutrophilic leukemia.
MedLine Citation:
PMID:  19652431     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We report a case of miliary tuberculosis associated with chronic neutrophilic leukemia (CNL). A 70-year-old woman was referred to our hospital complaining of a 1-month history of persistent fever and anorexia. Chest and abdominal computed tomography images revealed diffuse small nodular lesions in the bilateral lung fields and extreme splenomegaly. Sputum cultures isolated Mycobacterium tuberculosis. After anti-tuberculous therapy for 1 year, the patient underwent splenectomy for massive splenomegaly and progressive leukocytosis. The presence of the homozygous JAK2 V617F tyrosine kinase mutation was also demonstrated in the peripheral blood. She was finally diagnosed as having miliary tuberculosis associated with CNL based on the histopathological examination of spleen. The patient was treated with a daily dose of 500 mg of hydroxyurea. As a result, 18 months after the splenectomy, her leukocyte count was decreased and her clinical condition was markedly improved; there was no relapse of the CNL.
Authors:
Keishi Sugino; Kyoko Gocho; Hiroki Ota; Minaho Kobayashi; Go Sano; Kazutoshi Isobe; Yujiro Takai; Haruka Izumi; Yasunobu Kuraishi; Kazutoshi Shibuya; Sakae Homma
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-08-03
Journal Detail:
Title:  Internal medicine (Tokyo, Japan)     Volume:  48     ISSN:  1349-7235     ISO Abbreviation:  Intern. Med.     Publication Date:  2009  
Date Detail:
Created Date:  2009-08-04     Completed Date:  2009-11-04     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  9204241     Medline TA:  Intern Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1283-7     Citation Subset:  IM    
Affiliation:
Division of Respiratory Medicine, Toho University Omori Medical Center, Tokyo. keishi_sugino@ybb.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Bone Marrow / pathology
Female
Homozygote
Humans
Janus Kinase 2 / genetics
Leukemia, Neutrophilic, Chronic / complications*,  diagnosis*,  enzymology,  genetics
Mutation, Missense
Spleen / pathology
Tomography, X-Ray Computed
Tuberculosis, Miliary / complications*,  diagnosis*
Tuberculosis, Splenic / complications,  diagnosis
Chemical
Reg. No./Substance:
EC 2.7.1.112/JAK2 protein, human; EC 2.7.10.1/Janus Kinase 2

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