Tuberculosis-associated Immune Thrombocytopenia: A Case Report
Identifieur interne : 000684 ( Main/Exploration ); précédent : 000683; suivant : 000685Tuberculosis-associated Immune Thrombocytopenia: A Case Report
Auteurs : Reem J. Al Argan [Arabie saoudite] ; Abdulmohsen H. Al Elq [Arabie saoudite]Source :
- Saudi Journal of Medicine & Medical Sciences [ 1658-631X ] ; 2018.
Abstract
Various hematological manifestations are known to occur with tuberculosis (TB), but its association with immune thrombocytopenia is uncommon and not well recognized. Here, the case of a 39-year-old male who presented with a history of epistaxis and hematuria is described. The patient was found to have diffuse lymphadenopathy both clinically and radiologically. He was diagnosed with immune thrombocytopenia; however, there was a delay in the diagnosis of TB because of the patient's refusal of lymph node biopsy and late recognition of the association between TB and immune thrombocytopenia. Treatment with steroids without antituberculosis medications may have led to reactivation and dissemination of tuberculous infection in this patient. Later, the patient was readmitted with a suspected community-acquired pneumonia and the sputum smear was positive for acid-fast bacilli. Unfortunately, the patient died after he developed sepsis and multiorgan failure. The purpose of this case report is to highlight this rare combination and create awareness among clinicians to consider TB as an underlying etiology of immune thrombocytopenia, especially if there are other associated physical findings such as the presence of lymphadenopathy.
Url:
DOI: 10.4103/sjmms.sjmms_140_16
PubMed: 30787844
PubMed Central: 6196693
Affiliations:
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Al Argan</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam</wicri:regionArea><wicri:noRegion>Dammam</wicri:noRegion></affiliation></author><author><name sortKey="Al Elq, Abdulmohsen H" sort="Al Elq, Abdulmohsen H" uniqKey="Al Elq A" first="Abdulmohsen H." last="Al Elq">Abdulmohsen H. Al Elq</name><affiliation wicri:level="1"><nlm:aff id="aff1">Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia</nlm:aff><country xml:lang="fr">Arabie saoudite</country><wicri:regionArea>Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam</wicri:regionArea><wicri:noRegion>Dammam</wicri:noRegion></affiliation></author></analytic><series><title level="j">Saudi Journal of Medicine & Medical Sciences</title><idno type="ISSN">1658-631X</idno><idno type="eISSN">2321-4856</idno><imprint><date when="2018">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Various hematological manifestations are known to occur with tuberculosis (TB), but its association with immune thrombocytopenia is uncommon and not well recognized. Here, the case of a 39-year-old male who presented with a history of epistaxis and hematuria is described. The patient was found to have diffuse lymphadenopathy both clinically and radiologically. He was diagnosed with immune thrombocytopenia; however, there was a delay in the diagnosis of TB because of the patient's refusal of lymph node biopsy and late recognition of the association between TB and immune thrombocytopenia. Treatment with steroids without antituberculosis medications may have led to reactivation and dissemination of tuberculous infection in this patient. Later, the patient was readmitted with a suspected community-acquired pneumonia and the sputum smear was positive for acid-fast bacilli. Unfortunately, the patient died after he developed sepsis and multiorgan failure. The purpose of this case report is to highlight this rare combination and create awareness among clinicians to consider TB as an underlying etiology of immune thrombocytopenia, especially if there are other associated physical findings such as the presence of lymphadenopathy.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Varghese, B" uniqKey="Varghese B">B Varghese</name></author><author><name sortKey="Al Hajoj, S" uniqKey="Al Hajoj S">S Al-Hajoj</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kashyap, R" uniqKey="Kashyap R">R Kashyap</name></author><author><name sortKey="Chaudhary, Vp" uniqKey="Chaudhary V">VP Chaudhary</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Al Majed, Sa" uniqKey="Al Majed S">SA al-Majed</name></author><author><name sortKey="Al Momen, Ak" uniqKey="Al Momen A">AK al-Momen</name></author><author><name sortKey="Al Kassimi, Fa" uniqKey="Al Kassimi F">FA al-Kassimi</name></author><author><name sortKey="Al Zeer, A" uniqKey="Al Zeer A">A al-Zeer</name></author><author><name sortKey="Kambal, Am" uniqKey="Kambal A">AM Kambal</name></author><author><name sortKey="Baaqil, H" uniqKey="Baaqil H">H Baaqil</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Memish, Za" uniqKey="Memish Z">ZA Memish</name></author><author><name sortKey="Bamgboye, Ea" uniqKey="Bamgboye E">EA Bamgboye</name></author><author><name sortKey="Abuljadayel, N" uniqKey="Abuljadayel N">N Abuljadayel</name></author><author><name sortKey="Smadi, H" uniqKey="Smadi H">H Smadi</name></author><author><name sortKey="Abouzeid, Ms" uniqKey="Abouzeid M">MS Abouzeid</name></author><author><name sortKey="Al Hakeem, Rf" uniqKey="Al Hakeem R">RF Al Hakeem</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Avasthi, R" uniqKey="Avasthi R">R Avasthi</name></author><author><name sortKey="Mohanty, D" uniqKey="Mohanty D">D Mohanty</name></author><author><name sortKey="Chaudhary, Sc" uniqKey="Chaudhary S">SC Chaudhary</name></author><author><name sortKey="Mishra, K" uniqKey="Mishra K">K Mishra</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cines, Db" uniqKey="Cines D">DB Cines</name></author><author><name sortKey="Blanchette, Vs" uniqKey="Blanchette V">VS Blanchette</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Neunert, C" uniqKey="Neunert C">C Neunert</name></author><author><name sortKey="Lim, W" uniqKey="Lim W">W Lim</name></author><author><name sortKey="Crowther, M" uniqKey="Crowther M">M Crowther</name></author><author><name sortKey="Cohen, A" uniqKey="Cohen A">A Cohen</name></author><author><name sortKey="Solberg, L" uniqKey="Solberg L">L Solberg</name></author><author><name sortKey="Crowther, Ma" uniqKey="Crowther M">MA Crowther</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tsuro, K" uniqKey="Tsuro K">K Tsuro</name></author><author><name sortKey="Kojima, H" uniqKey="Kojima H">H Kojima</name></author><author><name sortKey="Mitoro, A" uniqKey="Mitoro A">A Mitoro</name></author><author><name sortKey="Yoshiji, H" uniqKey="Yoshiji H">H Yoshiji</name></author><author><name sortKey="Fujimoto, M" uniqKey="Fujimoto M">M Fujimoto</name></author><author><name sortKey="Uemura, M" uniqKey="Uemura M">M Uemura</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lin, Ch" uniqKey="Lin C">CH Lin</name></author><author><name sortKey="Chen, Tm" uniqKey="Chen T">TM Chen</name></author><author><name sortKey="Chang, Cc" uniqKey="Chang C">CC Chang</name></author><author><name sortKey="Tsai, Ch" uniqKey="Tsai C">CH Tsai</name></author><author><name sortKey="Chai, Wh" uniqKey="Chai W">WH Chai</name></author><author><name sortKey="Wen, Jh" uniqKey="Wen J">JH Wen</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Arabie saoudite</li></country></list><tree><country name="Arabie saoudite"><noRegion><name sortKey="Al Argan, Reem J" sort="Al Argan, Reem J" uniqKey="Al Argan R" first="Reem J." last="Al Argan">Reem J. Al Argan</name></noRegion><name sortKey="Al Elq, Abdulmohsen H" sort="Al Elq, Abdulmohsen H" uniqKey="Al Elq A" first="Abdulmohsen H." last="Al Elq">Abdulmohsen H. Al Elq</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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