Hypertrophic osteoarthropathy, tuberculoma of brain and cyanotic heart disease

Ray, Debarti; Menon, Ramesh; Menon, P. S. N.; Gupta, Gaurav; Shrivastava, Savitri; Tandon, R

doi:10.1007/bf02722205

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…Tuberculoma of the brain is a rare lesion in patients with congenital cyanotic heart disease. Moorthy et.al and Ray et.al 8,9 reported brainstem tuberculoma in an adult patient and tuberculoma in a child with cyanotic heart disease, respectively. Tuberculoma in the brain may have been as a result of hematogenous spread or rupture of tubercles in the brain.…”

Section: Discussionmentioning

confidence: 96%

CNS tuberculoma in patient with tetralogy of fallot: A case report

Chamlagain

Shah

Rijal

et al. 2021

Clinical Case Reports

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Section: Discussionmentioning

confidence: 96%

CNS tuberculoma in patient with tetralogy of fallot: A case report

Chamlagain

Shah

Rijal

et al. 2021

Clinical Case Reports

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“…HOA is characterized by a triad of arthritis, digital clubbing and new bone formation with periosteal inflammation [1]. Factors included in the pathogenesis are circulating vasodilators, tissue hypoxia, neural mechanisms and genetic factors [2].…”

Section: Figure 2 Discussionmentioning

confidence: 99%

Hypertrophic osteoarthropathy (HOA) in a child with congenital cyanotic heart disease - a case report

Choopa¹,

Mitchell²,

Menyatsoe³

et al. 2016

Pediatr Dimensions

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This is a case of a 12 year old girl who was diagnosed at birth with a double outlet right ventricle, pulmonary atresia, and interrupted inferior vena cava (IVC), with suspected Heterotaxy syndrome. A modified Blalock-Taussig shunt was done. She remained cyanotic due to a hypoplastic pulmonary artery bed and was considered unsuitable for further surgical intervention and was followed up at the Paediatric Cardiology clinic. At follow up at the age of 5 years old, cardiac catheterization to assess pulmonary arteries for possible surgery was conducted and she was incidentally found to have a dilated non-obstructed left renal pelvis. She was also found to be hypertensive and was treated with an angiotensin converting-enzyme inhibitor and a calcium channel blocker. Other treatment given for her cardiac disease included furosemide, digoxin, ferrous gluconate, and potassium supplementation. She developed progressive swelling and pain of her large joints from the age of 11 years old, and immune-mediated and destructive arthropathies were excluded. She was treated with a non-steroidal anti-inflammatory drug (NSAID). The swelling and pain of her large joints did not improve and radiologic investigations were found to be in keeping with secondary hypertrophic osteoarthropathy.In our patient, surgery was not possible for her heart condition and only conservative symptomatic treatment was offered. Her treatment remained a therapeutic challenge in view of the poly-pharmacy required to treat her multi-systemic condition. The side effects of these drugs are particularly undesirable in our patient, but had to be weighed against the poor quality of life she would have had if her treatment was focussed on her heart condition only.

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“…This patient, a young man of 23, presented with signs of brainstem involvement and was totally cured without any residual deficit with ATT. Ray et al [3] reported a case, a known patient of TOF, who presented with seizure and swollen joints and died after 25 days of treatment. Post-mortem examination revealed a tuberculoma in brain.…”

Section: Discussionmentioning

confidence: 99%

Tuberculoma of brain in cyanotic heart disease

Mohapatra

2015

J Pediatr Neurol

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Patients with cyanotic heart disease frequently suffer from brain abscesses. While most of such patients are treated conservatively, different modalities of surgical treatments are adapted depending upon the clinical situation. Though pulmonary tuberculosis is reported to be 2.5 times more common in children suffering from congenital heart disease than the general population of the same community, it is not known whether tuberculoma of brain is more common amongst them. Very few cases have been published reporting tuberculoma brain in patients with cyanotic heart disease. We report a case of cyanotic heart disease, which was treated as a case of bacterial endocarditis and later on suspected to have brain abscess until the patient deteriorated and became comatose requiring craniotomy. Tissue diagnosis of the lesion was tuberculoma. This observation necessitates the need for consideration of tuberculoma of brain in patients suffering from cyanotic heart diseases with neurological signs. Tuberculoma brain is medically treatable with good prognosis, if diagnosed early.

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Hypertrophic osteoarthropathy, tuberculoma of brain and cyanotic heart disease

Cited by 3 publications

References 12 publications

CNS tuberculoma in patient with tetralogy of fallot: A case report

CNS tuberculoma in patient with tetralogy of fallot: A case report

Hypertrophic osteoarthropathy (HOA) in a child with congenital cyanotic heart disease - a case report

Tuberculoma of brain in cyanotic heart disease

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