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

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

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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., Lacedonia, D., Sollitto, F., & Foschino, M. P. (Accepted/In press). Coexistent Sarcoidosis and Tuberculosis: A Case Report. Respiration. https://doi.org/10.1159/000457804