Rheumatoid arthritis (RA) is an autoimmune disease characterized by inflammation and progressive destruction of joints. 1 Over 23 million people worldwide suffer from RA. The disease has variable expression and outcome ranging from mild, limited disease to severe disease associated with progressive joint destruction and reduced survival. 1 Substantial comorbidity can be seen outside the musculoskeletal system, with excess cardiovascular risk, dyslipidemia, and propensity for infection partially related to the need for treatment with immunomodulatory agents. 2 Furthermore, RA causes a significant reduction in quality of life (QoL), impacting the physical, emotional, occupational, and economic aspects of patients' lives. 3 The combination of costs associated with long-term therapy and socio-economic consequences of RA have a major impact on healthcare systems and on society in general. 4
A 52-year-old white woman and her 61-year-old white brother separately presented with gradually worsening dyspnea on exertion and cough, and evidence of interstitial lung disease on chest imaging.
La tuberculosis es una de las enfermedades que más ha impactado en la sociedad a nivel mundial siendo influenciada por el VIH, los patrones migratorios y la inducción de la medicación antituberculosa. La forma extrapulmonar es de más baja frecuencia de presentación siendo más característica en los pacientes inmunocomprometidos, cuyas manifestaciones clínicas son inespecíficas, por lo que constituye un reto diagnóstico para los clínicos, en la mayoría de los casos retardando su detección y tratamiento.
Se presenta el caso clínico de un paciente inmunocompetente que consulta por cuadro de 6 años de evolución de disfagia progresiva y síntomas constitucionales, en quien se encontró compromiso por tuberculosis a nivel esofágico y laríngeo que explicaban los síntomas de ingreso así como compromiso pulmonar sin clara sintomatología. Cuadro llamativo y de relevancia por su forma de presentación de alta contagiosidad en un paciente sin inmunocompromiso.
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