Concurrent severe pulmonary tuberculosis with Evans syndrome: a case report with literature review
Abstract Background Tuberculosis is a bacterial infection involving multiple organs and systems. Its hematological presentation mainly includes anemia and leukocytosis. Evans syndrome is a rare autoimmune disease characterized by autoimmune hemolytic anemia, immune thrombocytopenia, and neutropenia,...
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-022-07512-1 |
| _version_ | 1811342451296698368 |
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| author | Xiao-hong Pan Jie-kun Xu Lei Pan Cai-hong Wang Xiao-qing Huang Jun-ke Qiu Xiao-bo Ji Min-jie Mao |
| author_facet | Xiao-hong Pan Jie-kun Xu Lei Pan Cai-hong Wang Xiao-qing Huang Jun-ke Qiu Xiao-bo Ji Min-jie Mao |
| author_sort | Xiao-hong Pan |
| collection | DOAJ |
| description | Abstract Background Tuberculosis is a bacterial infection involving multiple organs and systems. Its hematological presentation mainly includes anemia and leukocytosis. Evans syndrome is a rare autoimmune disease characterized by autoimmune hemolytic anemia, immune thrombocytopenia, and neutropenia, with positive results for the direct Coombs test and platelet antibodies. The cooccurrence of tuberculosis and Evans syndrome is rarely reported. Case presentation A 69-year-old female presented with a fever and shortness of breath. Her chest computerized tomography scan showed extensive miliary nodules in the bilateral lung fields. She rapidly developed respiratory failure that required endotracheal intubation and mechanical ventilation. The acid-fast bacilli sputum smear results indicated a grade of 3+. Later on, blood testing revealed hemolytic anemia, a positive direct Coombs test result, and the presence of the platelet antibody IgG. This patient was diagnosed as having disseminated pulmonary tuberculosis and Evans syndrome. She successfully recovered after treatment with antituberculosis drugs and glucocorticoids. Conclusions Tuberculosis can occur together with Evans syndrome. Affected patients should receive both antituberculosis and immunosuppressive drugs. |
| first_indexed | 2024-04-13T19:12:31Z |
| format | Article |
| id | doaj.art-8e790c17330d411192f0497dd5dec922 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-13T19:12:31Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-8e790c17330d411192f0497dd5dec9222022-12-22T02:33:48ZengBMCBMC Infectious Diseases1471-23342022-06-012211610.1186/s12879-022-07512-1Concurrent severe pulmonary tuberculosis with Evans syndrome: a case report with literature reviewXiao-hong Pan0Jie-kun Xu1Lei Pan2Cai-hong Wang3Xiao-qing Huang4Jun-ke Qiu5Xiao-bo Ji6Min-jie Mao7Tuberculosis Care Unit, Affiliated Hangzhou Chest Hospital, Zhejiang University School of MedicineTuberculosis Care Unit, Affiliated Hangzhou Chest Hospital, Zhejiang University School of MedicineTuberculosis Care Unit, Affiliated Hangzhou Chest Hospital, Zhejiang University School of MedicineTuberculosis Care Unit, Affiliated Hangzhou Chest Hospital, Zhejiang University School of MedicineTuberculosis Care Unit, Affiliated Hangzhou Chest Hospital, Zhejiang University School of MedicineTuberculosis Care Unit, Affiliated Hangzhou Chest Hospital, Zhejiang University School of MedicineTuberculosis Care Unit, Affiliated Hangzhou Chest Hospital, Zhejiang University School of MedicineTuberculosis Care Unit, Affiliated Hangzhou Chest Hospital, Zhejiang University School of MedicineAbstract Background Tuberculosis is a bacterial infection involving multiple organs and systems. Its hematological presentation mainly includes anemia and leukocytosis. Evans syndrome is a rare autoimmune disease characterized by autoimmune hemolytic anemia, immune thrombocytopenia, and neutropenia, with positive results for the direct Coombs test and platelet antibodies. The cooccurrence of tuberculosis and Evans syndrome is rarely reported. Case presentation A 69-year-old female presented with a fever and shortness of breath. Her chest computerized tomography scan showed extensive miliary nodules in the bilateral lung fields. She rapidly developed respiratory failure that required endotracheal intubation and mechanical ventilation. The acid-fast bacilli sputum smear results indicated a grade of 3+. Later on, blood testing revealed hemolytic anemia, a positive direct Coombs test result, and the presence of the platelet antibody IgG. This patient was diagnosed as having disseminated pulmonary tuberculosis and Evans syndrome. She successfully recovered after treatment with antituberculosis drugs and glucocorticoids. Conclusions Tuberculosis can occur together with Evans syndrome. Affected patients should receive both antituberculosis and immunosuppressive drugs.https://doi.org/10.1186/s12879-022-07512-1TuberculosisEvans syndromeAutoimmune hemolytic anemiaCoombs testGlucocorticoids |
| spellingShingle | Xiao-hong Pan Jie-kun Xu Lei Pan Cai-hong Wang Xiao-qing Huang Jun-ke Qiu Xiao-bo Ji Min-jie Mao Concurrent severe pulmonary tuberculosis with Evans syndrome: a case report with literature review BMC Infectious Diseases Tuberculosis Evans syndrome Autoimmune hemolytic anemia Coombs test Glucocorticoids |
| title | Concurrent severe pulmonary tuberculosis with Evans syndrome: a case report with literature review |
| title_full | Concurrent severe pulmonary tuberculosis with Evans syndrome: a case report with literature review |
| title_fullStr | Concurrent severe pulmonary tuberculosis with Evans syndrome: a case report with literature review |
| title_full_unstemmed | Concurrent severe pulmonary tuberculosis with Evans syndrome: a case report with literature review |
| title_short | Concurrent severe pulmonary tuberculosis with Evans syndrome: a case report with literature review |
| title_sort | concurrent severe pulmonary tuberculosis with evans syndrome a case report with literature review |
| topic | Tuberculosis Evans syndrome Autoimmune hemolytic anemia Coombs test Glucocorticoids |
| url | https://doi.org/10.1186/s12879-022-07512-1 |
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