Cerebral tuberculomas in a 6-year-old girl causing central diabetes insipidus.
Cerebral tuberculomas in a 6-year-old girl causing central diabetes insipidus.
复制标题
一名 6 岁女孩的脑结核瘤导致中枢性尿崩症。
DOI：
10.1136/bcr-2018-226590
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发表时间：
2018
期刊：
影响因子：
0.9
通讯作者：
Grandjean,Louis
中科院分区：
文献类型：
--
作者：
Chellen,Shavindra;Whittaker,Elizabeth;Eisenhut,Michael;Grandjean,Louis
一名六岁女孩表现出严重的额部头痛。她有3个月的嗜睡、食欲减退、体重减轻、咳嗽和间歇性发烧的病史。胸部x线显示左上叶实变，头部CT显示双脑半球多发强化病灶，周围明显水肿。由于强烈怀疑是结核病，她住院并接受抗结核治疗和类固醇治疗。随后，通过诱导痰的PCR阳性证实肺部感染结核分枝杆菌。脑脊液（CSF）分析正常，呈阴性。tuberculosison PCR。在治疗的第一周，患者出现多尿、夜尿和烦渴，并被诊断为中枢性尿崩症。她开始使用去氨加压素，这迅速改善了她的症状，她继续使用去氨加压素3个月。目前，她身体健康，对结核病治疗反应良好。
A 6-year-old girl presented acutely with worsening frontal headaches. She had a 3-month history of lethargy, reduced appetite, weight loss, cough and intermittent fevers. A chest X-ray showed a left upper lobe consolidation, and a CT head showed multiple enhancing lesions with significant surrounding oedema in both cerebral hemispheres. Due to the strong suspicion of tuberculosis (TB), she was admitted and treated with anti-TB therapy and steroids. Following this, pulmonary infection withMycobacterium tuberculosiswas confirmed by a positive PCR from induced sputum. Cerebral spinal fluid (CSF) analysis was normal and tested negative forM. tuberculosison PCR. During her first week of treatment, she developed polyuria, nocturia and polydipsia and was diagnosed with central diabetes insipidus. She was started on desmopressin which rapidly improved her symptoms, and she was continued on desmopressin for 3 months. Currently, she remains well and has shown a good response to TB treatment.