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无反应性结核病作为特殊类型的结核病,近年来国内屡有个案报道,并有增多趋势。本病特点为:一、发病关键是机体细胞免疫功能缺陷,糖皮质激素有促发本病发病的作用;二、全身多器官出现粟粒性病变,镜下病变为干酪样坏死、无增殖性或渗出性反应,有大量抗酸杆菌;三、临床突出表现为发热,肝、脾及淋巴结肿大,呼吸系症状与体征少见;四、常伴有各种血液学改变;五、胸片上可无粟粒样改变;六、抗结核化疗并用免疫增强剂可能对本病有效。
Atypical tuberculosis is a special type of tuberculosis. In recent years, it has been repeatedly reported and increased in China. The disease is characterized by: First, the key is the incidence of cellular immune dysfunction, glucocorticoid have contributed to the pathogenesis of this disease; Second, the whole body multiple organ miliary lesions, microscopic lesions of caseous necrosis, non-proliferative or Exudative reaction, a large number of acid-fast bacilli; Third, clinical manifestations of fever, liver, spleen and lymph nodes, respiratory symptoms and signs of rare; Fourth, often accompanied by a variety of hematological changes; No miliary-like changes; six anti-TB chemotherapy and immunostimulants may be effective in this disease.