[A case of tuberculosis pleuritis with high serum soluble IL-2 receptor].
A 56-year-old man was admitted to our hospital because of bilateral pleural effusion. Computed tomography revealed solitary mediastinal lymphadenopathy, splenomegaly and a small amount of ascites. No lung parenchymal lesion was seen. Although lymphocyte predominance without atypia and a high adenocine deaminase concentration in the pleural fluid were compatible with tuberculous pleurisy, no mycobacteria could be detected either with Ziehl-Nielsen stain or with PCR. Because the serum soluble interleukin 2 receptor (sIL-2 R) level was unexpectedly high (> 8,000 U/ml), and a level not previously reported in benign diseases, we performed thoracoscopy- and mediastinoscopy-assisted biopsies, both of which eventually confirmed the diagnosis of tuberculosis. After a 4-drug anti-tuberculous regimen was initiated, pleural effusion and ascites subsided, with a marked decrease in the sIL-2R level. This case indicates that in tuberculous pleurisy, serum sIL-2R can rise to a level suggestive of hematological malignancies, it and also illustrates the validity of thoracoscopy-assisted pleural biopsy in such situations.
Department of Respiratory Disease, National Minami-Fukuoka Hospital, 4-39-1, Yakatabaru, Minami-ku, Fukuoka-city, Fukuoka, Japan.
Yuya
Y
Fujiwara
Naotsugu
N
Takahashi
Hiroshi
H
Koto
Hiroko
H
Nogami
Kinji
K
Yokota
Terufumi
T
Shimoda
Shunsuke
S
Shoji
Sankei
S
Nishima
Chiharu
C
Kubo
D015415:Biomarkers / Q000097:blood; D001706:Biopsy / Q000379:methods; D003937:Diagnosis, Differential; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008481:Mediastinoscopy; D008482:Mediastinum; D008875:Middle Aged; D010994:Pleura / Q000473:pathology; D015375:Receptors, Interleukin-2 / Q000097:blood*; D012995:Solubility; D013906:Thoracoscopy; D014396:Tuberculosis, Pleural / Q000175:diagnosis* / Q000473:pathology
D015415:Biomarkers; D015375:Receptors, Interleukin-2