title: Miliary tuberculosis associated with chronic neutrophilic leukemia.
abstract: 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: Division of Respiratory Medicine, Toho University Omori Medical Center, Tokyo. keishi_sugino@ybb.ne.jp
authors: Keishi
authors: K
authors: Sugino
authors: Kyoko
authors: K
authors: Gocho
authors: Hiroki
authors: H
authors: Ota
authors: Minaho
authors: M
authors: Kobayashi
authors: Go
authors: G
authors: Sano
authors: Kazutoshi
authors: K
authors: Isobe
authors: Yujiro
authors: Y
authors: Takai
authors: Haruka
authors: H
authors: Izumi
authors: Yasunobu
authors: Y
authors: Kuraishi
authors: Kazutoshi
authors: K
authors: Shibuya
authors: Sakae
authors: S
authors: Homma
mesh_terms: D000368:Aged; D001853:Bone Marrow / Q000473:pathology; D005260:Female; D006720:Homozygote; D006801:Humans; D053614:Janus Kinase 2 / Q000235:genetics; D015467:Leukemia, Neutrophilic, Chronic / Q000150:complications* / Q000175:diagnosis* / Q000201:enzymology / Q000235:genetics; D020125:Mutation, Missense; D013154:Spleen / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014391:Tuberculosis, Miliary / Q000150:complications* / Q000175:diagnosis*; D014400:Tuberculosis, Splenic / Q000150:complications / Q000175:diagnosis
chemical_list: C507924:JAK2 protein, human; D053614:Janus Kinase 2