Coexistent Sarcoidosis and Tuberculosis: A Case Report

Cristiano Carbonelli, Ernesto Giuffreda, Antonio Palmiotti, Domenico Loizzi, Filippo Lococo, Elisiana Carpagnano, Donato Lacedonia, Francesco Sollitto, Maria Pia Foschino

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Necrotizing granulomatous diseases of the lungs are usually dependent on a narrow range of differential diagnoses. Tuberculosis (TB) is responsible for the largest number of cases, while necrotizing sarcoidosis is generally considered a rare and easily distinguishable disease substantially based on histological features. However, this entity has become a viable diagnosis in the absence of mycobacteria isolation or when a remarkable clinical improvement cannot be achieved with the combination of anti-TB drugs at full dosage. The classic manifestations of TB and sarcoidosis have an overlapping range for which it is sometimes difficult to make a clinical diagnosis. Furthermore, the role of mycobacteria as a trigger antigen capable of evoking the clinical expression of sarcoidosis is a hypothesis supported by evidence from some cases. We report a case of bilateral tuberculous pleurisy in a 45-year-old male native of a North-African region with an atypical severe multisystem disease characterized by a fever resistant to anti-TB therapy and respondent to corticosteroid treatment. The choice to continue both steroid and anti-TB therapy proved to be correct for the late evidence of TB mycobacterial growth only on pleural specimens. The case described is suggestive of a coexistent systemic sarcoid manifestation and low-antigen TB, which is an underrecognized entity in the medical literature.

Original languageEnglish
JournalRespiration
DOIs
Publication statusAccepted/In press - Feb 9 2017

Fingerprint

Sarcoidosis
Tuberculosis
Mycobacterium
Pleural Tuberculosis
Antigens
Lung Diseases
Adrenal Cortex Hormones
Differential Diagnosis
Fever
Steroids
Therapeutics
Growth
Pharmaceutical Preparations

Keywords

  • Pleural biopsy
  • Sarcoidosis
  • Thoracoscopy
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Carbonelli, C., Giuffreda, E., Palmiotti, A., Loizzi, D., Lococo, F., Carpagnano, E., ... Foschino, M. P. (Accepted/In press). Coexistent Sarcoidosis and Tuberculosis: A Case Report. Respiration. https://doi.org/10.1159/000457804

Coexistent Sarcoidosis and Tuberculosis : A Case Report. / Carbonelli, Cristiano; Giuffreda, Ernesto; Palmiotti, Antonio; Loizzi, Domenico; Lococo, Filippo; Carpagnano, Elisiana; Lacedonia, Donato; Sollitto, Francesco; Foschino, Maria Pia.

In: Respiration, 09.02.2017.

Research output: Contribution to journalArticle

Carbonelli, C, Giuffreda, E, Palmiotti, A, Loizzi, D, Lococo, F, Carpagnano, E, Lacedonia, D, Sollitto, F & Foschino, MP 2017, 'Coexistent Sarcoidosis and Tuberculosis: A Case Report', Respiration. https://doi.org/10.1159/000457804
Carbonelli C, Giuffreda E, Palmiotti A, Loizzi D, Lococo F, Carpagnano E et al. Coexistent Sarcoidosis and Tuberculosis: A Case Report. Respiration. 2017 Feb 9. https://doi.org/10.1159/000457804
Carbonelli, Cristiano ; Giuffreda, Ernesto ; Palmiotti, Antonio ; Loizzi, Domenico ; Lococo, Filippo ; Carpagnano, Elisiana ; Lacedonia, Donato ; Sollitto, Francesco ; Foschino, Maria Pia. / Coexistent Sarcoidosis and Tuberculosis : A Case Report. In: Respiration. 2017.
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