[A case of tuberculous meningitis followed by tuberculoma with pan-hypopituitarism].
We reported a case who suffered from tuberculous meningitis at 10 months of age, and progressed to basal tuberculoma despite intensive drug therapy with isoniazid, rifampin, and streptomycin. Pan-hypopituitaliam due to basal tuberculoma was effectively replaced by the administration of anti-diuretic hormone (DDAVP) and levothyroxine sodium. Basal tuberculoma was finally removed by surgical operation. Histopathological examination of the tuberculoma revealed Mycobacterium tuberculosis and Langhans giant cells. During the 6 years after the operation, her growth rate was found to be retarded, and the administration of human growth hormone was started. Remarkable catch-up growth was demonstrated. We like to emphasize that infantile tuberculosis, mostly a result of intafamilial transmission, may manifest meningitis in the early phase of the disease, and it sometimes progresses to basal tuberculoma unresponsive to anti-mycobacterial drug therapy.
Tomono
N
N
Department of Pediatrics, Yokohama City University School of Medicine.
Mori
M
M
Kikuchi
N
N
Imagawa
T
T
Katakura
S
S
Aihara
Y
Y
Yokota
S
S
D002648:Child; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy / Q000209:etiology*; D013974:Thyroxine / Q000008:administration & dosage; D014375:Tuberculoma / Q000209:etiology*; D014390:Tuberculosis, Meningeal / Q000150:complications*
D003894:Deamino Arginine Vasopressin; D013974:Thyroxine