Co-existence of Pulmonary Tuberculosis and Interstitial Lung Disease in a Patient of Connective Tissue Disorder: A Case Report
Pulmonary involvement is common in patients with systemic sclerosis. The most common underlying histology is Non Specific Interstitial Pneumonia (NSIP). Disrupted immunity from the disease or associated medication may render such patients prone to develop tuberculosis infection. A 55-year-old female...
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JCDR Research and Publications Private Limited
2020-04-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/13623/43556_F(SL)_CE[Ra1]_(SHU)_PF1(ShG_SHU)_GC(Su_KM)_PN(SL).pdf |
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| author | Huma Firdaus Nafees Ahmad Khan Ummul Baneen Mohammad Shameem Rakesh Bhargava |
| author_facet | Huma Firdaus Nafees Ahmad Khan Ummul Baneen Mohammad Shameem Rakesh Bhargava |
| author_sort | Huma Firdaus |
| collection | DOAJ |
| description | Pulmonary involvement is common in patients with systemic sclerosis. The most common underlying histology is Non Specific Interstitial Pneumonia (NSIP). Disrupted immunity from the disease or associated medication may render such patients prone to develop tuberculosis infection. A 55-year-old female patient presented with chief complaints of shortness of breath from past five years which was gradually progressive, cough initially dry later with minimal expectoration, low grade fever from past two months. She also gave history of bluish discolouration of fingers tips on exposure to cold water. On examination there was restrictive mouth opening, thickened skin over hands, forearm, face, neck and trunk on pinching. Sclerodactyly was present with clubbing grade 2. On auscultation bilateral fine crepts were present. Serum ANA was highly raised and Scl 70 was positive. PFT was suggestive of restrictive ventilatory abnormality. Sputum smear for AFB was found to be positive. HRCT thorax was suggestive of NSIP. Patient was put on antituberculer treatment under DOTS category 1; nifedipine, pentoxyphylline and nitroglycerine gel was started for raynauds phenomenon. Chemotherapy for systemic sclerosis was given with cyclophosphamide infusion in six cycles every four weeks. |
| first_indexed | 2024-12-14T19:47:23Z |
| format | Article |
| id | doaj.art-7733dc6da01a40c69ac399c15b2d7bd7 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-14T19:47:23Z |
| publishDate | 2020-04-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-7733dc6da01a40c69ac399c15b2d7bd72022-12-21T22:49:31ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2020-04-01144LD01LD0310.7860/JCDR/2020/43556.13623Co-existence of Pulmonary Tuberculosis and Interstitial Lung Disease in a Patient of Connective Tissue Disorder: A Case ReportHuma Firdaus0Nafees Ahmad Khan1Ummul Baneen2Mohammad Shameem3Rakesh Bhargava4Senior Resident, Department of TB and Respiratory Diseases, JN Medical College, Aligarh, Uttar Pradesh, India.Assistant Professor, Department of TB and Respiratory Diseases, JN Medical College, Aligarh, Uttar Pradesh, India.Assistant Professor, Department of TB and Respiratory Diseases, JN Medical College, Aligarh, Uttar Pradesh, India.Professor, Department of TB and Respiratory Diseases, JN Medical College, Aligarh, Uttar Pradesh, India.Professor, Department of TB and Respiratory Diseases, JN Medical College, Aligarh, Uttar Pradesh, India.Pulmonary involvement is common in patients with systemic sclerosis. The most common underlying histology is Non Specific Interstitial Pneumonia (NSIP). Disrupted immunity from the disease or associated medication may render such patients prone to develop tuberculosis infection. A 55-year-old female patient presented with chief complaints of shortness of breath from past five years which was gradually progressive, cough initially dry later with minimal expectoration, low grade fever from past two months. She also gave history of bluish discolouration of fingers tips on exposure to cold water. On examination there was restrictive mouth opening, thickened skin over hands, forearm, face, neck and trunk on pinching. Sclerodactyly was present with clubbing grade 2. On auscultation bilateral fine crepts were present. Serum ANA was highly raised and Scl 70 was positive. PFT was suggestive of restrictive ventilatory abnormality. Sputum smear for AFB was found to be positive. HRCT thorax was suggestive of NSIP. Patient was put on antituberculer treatment under DOTS category 1; nifedipine, pentoxyphylline and nitroglycerine gel was started for raynauds phenomenon. Chemotherapy for systemic sclerosis was given with cyclophosphamide infusion in six cycles every four weeks.https://jcdr.net/articles/PDF/13623/43556_F(SL)_CE[Ra1]_(SHU)_PF1(ShG_SHU)_GC(Su_KM)_PN(SL).pdfraynaud’s pheomenonsputum positive pulmonary tuberculosissystemic sclerosis |
| spellingShingle | Huma Firdaus Nafees Ahmad Khan Ummul Baneen Mohammad Shameem Rakesh Bhargava Co-existence of Pulmonary Tuberculosis and Interstitial Lung Disease in a Patient of Connective Tissue Disorder: A Case Report Journal of Clinical and Diagnostic Research raynaud’s pheomenon sputum positive pulmonary tuberculosis systemic sclerosis |
| title | Co-existence of Pulmonary Tuberculosis and Interstitial Lung Disease in a Patient of Connective Tissue Disorder: A Case Report |
| title_full | Co-existence of Pulmonary Tuberculosis and Interstitial Lung Disease in a Patient of Connective Tissue Disorder: A Case Report |
| title_fullStr | Co-existence of Pulmonary Tuberculosis and Interstitial Lung Disease in a Patient of Connective Tissue Disorder: A Case Report |
| title_full_unstemmed | Co-existence of Pulmonary Tuberculosis and Interstitial Lung Disease in a Patient of Connective Tissue Disorder: A Case Report |
| title_short | Co-existence of Pulmonary Tuberculosis and Interstitial Lung Disease in a Patient of Connective Tissue Disorder: A Case Report |
| title_sort | co existence of pulmonary tuberculosis and interstitial lung disease in a patient of connective tissue disorder a case report |
| topic | raynaud’s pheomenon sputum positive pulmonary tuberculosis systemic sclerosis |
| url | https://jcdr.net/articles/PDF/13623/43556_F(SL)_CE[Ra1]_(SHU)_PF1(ShG_SHU)_GC(Su_KM)_PN(SL).pdf |
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