難治性潰瘍性口内炎が初発症状と考えられた急性型成人T細胞白血病の1例 A case of acute adult T-cell leukemia with severe ulcerative stomatitis considered as an early symptom

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著者

    • 松井 竜太郎 MATSUI Ryutaro
    • 鹿児島大学大学院医歯学総合研究科顎顔面機能再建学講座顎顔面疾患制御学分野 Maxillofacial Diagnostic and Surgical Sciences, Department of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences
    • 山口 孝二郎 YAMAGUCHI Koujiro
    • 鹿児島大学大学院医歯学総合研究科顎顔面機能再建学講座顎顔面疾患制御学分野 Maxillofacial Diagnostic and Surgical Sciences, Department of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences
    • 向井 洋 MUKAI Hiroshi
    • 鹿児島大学大学院医歯学総合研究科顎顔面機能再建学講座顎顔面疾患制御学分野 Maxillofacial Diagnostic and Surgical Sciences, Department of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences
    • 杉原 一正 SUGIHARA Kazumasa
    • 鹿児島大学大学院医歯学総合研究科顎顔面機能再建学講座顎顔面疾患制御学分野 Maxillofacial Diagnostic and Surgical Sciences, Department of Oral and Maxillofacial Rehabilitation, Kagoshima University Graduate School of Medical and Dental Sciences

抄録

In March 1999, a 70-year-old man presented with ulceration of the oral mucosa and difficulty in swallowing accompanied by pain.<BR>Clinically, the oral ulcerations were characterized by a punched-out appearance, and the circumscribed lesions showed a trend toward bleeding with pain. The clinical diagnosis was herpetic gingivostomatitis.<BR>After admission, the patient received systemic antiviral agents (aciclovir), and corticosteroid ointment was applied to the oral lesions. Despite treatment, the oral ulcers remained unchanged, and the patient had a fever of unknown origin. Microscopic examination of a specimen of the oral ulcer revealed no definitive evidence of viral infection. On immunological examination, anti-ATLA was positive, and PPD reaction was negative. Subpopulation analysis of blood lymphocytes showed an increase in CD 4-positive cells and an increased CD 4/CD 8 ratio.<BR>Viral esophagitis was confirmed histopathologically by gastrointestinal examination. These findings suggested severe immune deficiency. A diagnosis of acute adult T-cell leukemia (ATL) was made at the Third Department of Internal Medicine of our university hospital. Chemotherapy for ATL was performed; however, the patient died of respiratory dysfunction caused by ATL cell infiltration of the lung in May 2000.

収録刊行物

  • 日本口腔外科学会雑誌  

    日本口腔外科学会雑誌 50(4), 251-254, 2004-04-20 

    Japanese Society of Oral and Maxillofacial Surgeons

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各種コード

  • NII論文ID(NAID)
    10018620229
  • NII書誌ID(NCID)
    AN00189163
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    00215163
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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