A rare case of coexistence of Wegener’s granulomatosis and pulmonary tuberculosis with subsequent development of thrombosis of the cerebral veins

Rahimi, Zohreh; Cegolon﻿﻿, Luca; Jafari, Nematollah Jonaidi; Gholami, Nasrin; Mousavi, Seyed Vahid; Allahyari, Fakhri; Azami, Atena; Javanbakht, Mohammad

doi:10.1186/s12879-021-06583-w

Cited by 5 publications

(2 citation statements)

References 36 publications

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“…Our patient was also found to have both TB and GPA, but with venous thrombosis at the time of presentation which is a very rare entity. 8 The complexity of the possible inter relationships between the disease entities makes more than one hypothesis possible here and it is virtually impossible to determine which one leads to the other. But the simultaneous detection of three entities which can otherwise exist independently also, makes this case worthwhile and intriguing for the readers.…”

Section: Discussionmentioning

confidence: 99%

Coexistence of Pulmonary Thromboembolism, Pulmonary Tuberculosis and Granulomatosis with Polyangiitis

Pavirala,

Khurana,

Kadian

et al. 2024

Sultan Qaboos Univ Med J

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Granulomatosis with polyangiitis (GPA) is a rare autoimmune disease with multi‐system involvement. It involves the upper respiratory tract, lungs and kidneys. A 36-year-old female patient presented with complaints of low-grade fever, dry cough and loss of appetite initially followed by dyspnea, purpuric skin lesions, right lower limb swelling with pain and redness. Her chest radiograph revealed right upper lobe cavitary lesion with consolidation in right lower lobe. Mycobacterium tuberculosis was detected in sputum and Broncho alveolar lavage (BAL) via Cartridge based nucleic acid amplification assay (CB-NAAT). Later, Computed Tomography Pulmonary Angiography (CTPA) revealed bilateral pulmonary artery thromboembolism. Furthermore, her C-ANCA was positive, serum creatinine was rising, urine microscopy had red cell casts and lower limb venous doppler revealed DVT. Histopathological examination of the skin lesion revealed vasculitis. Based on the above findings, diagnosis of GPA was comfortably made. Patient improved with pulse steroids, cyclophosphamide, anticoagulants and anti-tuberculous therapy (ATT). Keywords: Granulomatosis with polyangiitis (GPA), Pulmonary Tuberculosis, Pulmonary thrombo-embolism, deep venous thrombosis, vasculitis, c-ANCA.

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Section: Discussionmentioning

confidence: 99%

Coexistence of Pulmonary Thromboembolism, Pulmonary Tuberculosis and Granulomatosis with Polyangiitis

Pavirala,

Khurana,

Kadian

et al. 2024

Sultan Qaboos Univ Med J

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“…The presence of antibodies in patients with tuberculosis may reflect the relationship between the pathogenesis of those diseases with the possibility of cross-reactivity between vimentin and M. tuberculosis peptides ( 71 – 73 ).…”

Section: Discussionmentioning

confidence: 99%

Identification of autoimmune markers in pulmonary tuberculosis

et al. 2023

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IntroductionPathogenesis of many autoimmune diseases is mainly promoted by poorly regulated and/or wrong targeted immune response to pathogens including M. tuberculosis. Autoimmunity is one of the processes with are characteristics of tuberculosis (Tbc). The aim was to determine the autoimmune clinical and immunological features in patients with pulmonary Tbc.Materials and methodsA prospective comparative study was performed in 2017 – 2019 with the inclusion of 46 patients with Tbc. The trigger factors and clinical manifestations, autoantibodies, peripheral blood B cell subsets were stained with fluorochrome-conjugated monoclonal antibodies. 40 healthy volunteers in the control group, were matched for age with no chronic diseases, contacts with TB patients and changes in their laboratory parameters. A statistical analysis was done with GraphPad Prism 6, Statistica 10 (Statsoft) and MedCalc – version 18.2.1 values.ResultsThere were no significant ASIA triggers in Tbc patients and control group. 21.1% of Tbc patients had a high level of a rheumatoid factor and in 47.4% complement system factor C3 was high; anti-MCV was detected in 60.7% of Tbc patients. Relative and absolute frequencies of “naïve” Bm1 cells and eBm5 were significantly decreased and activated pre-germinal-center Bm2’ cells were significantly increased in Tbc patients. The CD24++CD38++ B cells were increased in Tbc vs control group (10.25% vs 5.42%), p < 0.001, and 19 cell/1μL (10; 290 vs 11 cell/1μL (6; 20), p = 0.029, respectively). The frequency of CXCR3+CCR4– Tfh1 cells was significantly lower in Tbc vs control one (26.52% vs. 31.00%, p = 0.004), while CXCR3–CCR4+ Tfh2 cells were increased in Tbc (20.31% vs. controls (16.56%, p = 0.030). The absolute numbers of Tfh1 cells were decreased in the Tbc vs. control (24 cell/1μL vs. 37 cell/1μL p = 0.005).ConclusionThe results of our study showed that the detection of a rheumatoid factor, the components of complement system and anti-MCV in complex with alterations in B cells and follicular Th cell subsets may indicate a presence of autoimmunity in the pathogenesis of tuberculosis, but they are not specific. The indicators of autoimmune-related provide new opportunities in the Tbc treatment.

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Covid-19 vaccines and neurological complications: a systematic review

Allahyari

Molaee

Nejad

2022

Zeitschrift Für Naturforschung C

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The COVID-19 mainly causes respiratory disorders with high infection and severe morbidity and mortality. Neurologists have concerns about potential neurological side effects, profits, and timing of COVID-19 vaccines. This study aimed to review systematically research for the COVID-19 vaccine and neurological complications. Data was searched in Scopus, ISI web of knowledge, Medline, PubMed, Wiley, Embase, International Clinical Trials Registry Platform and Clinical Trials, Cochrane Library, and Google Scholar. Two reviewer authors individually searched and assessed the titles and abstracts of all articles. The third reviewer resolved disagreement between them. Data were documented regarding study location, study design, type of complications, number of patients, various types of COVID-19 vaccine, and type of neurological complications. Six studies in COVID-19 vaccine and neurological complications include two studies about neurological manifestations after the mRNA vaccines, four records about side effects of vector-based vaccine were included in the study. The main neurological complication associated mRNA vaccines were body aches, paresthesia, and difficulty walking, erythema migrans lesion, fatigue, myalgia, and pain in the left lateral deltoid region. The major neurological complication related to vector-based vaccines were urinary retention difficulty, feeding and ambulating, arm soreness, mild fatigue, chills, left-sided facial droop, headaches, a generalized epileptic seizure, hemianopia, and mild aphasia, acute somnolence and right-hand hemiparesis, acute transverse myelitis, deep vein thrombosis in her left leg, a vigilance disorder and a twitching, a severe immobilizing opsoclonus myoclonus syndrome, and encephalitis. A large spectrum of severe neurological unfavorable has been reported. These complications could occur as a result of molecular stimulation and later neuronal damage. Generally, the advantages of COVID‐19 vaccination are dominant on the risks of a neurological complication at both individual and population levels. Future investigations will be required to find any relationship between neurological complications and COVID‐19 vaccines principally as new strains of the virus and new vaccines are technologically advanced against them.

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A rare case of coexistence of Wegener’s granulomatosis and pulmonary tuberculosis with subsequent development of thrombosis of the cerebral veins

Cited by 5 publications

References 36 publications

Coexistence of Pulmonary Thromboembolism, Pulmonary Tuberculosis and Granulomatosis with Polyangiitis

Coexistence of Pulmonary Thromboembolism, Pulmonary Tuberculosis and Granulomatosis with Polyangiitis

Identification of autoimmune markers in pulmonary tuberculosis

Covid-19 vaccines and neurological complications: a systematic review

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