Tuberculosis occurring in adult idiopathic pulmonary hemosiderosis
Nesrine Belgacem1,&, Najla Lassoued1, Hassène Baïli1, Safa Trabelsi1, Maher Béji1, Salem Bouomrani1
1Department of Internal Medicine, Gabès Military Hospital, Gabès, Tunisia
Nesrine Belgacem, Department of Internal Medicine, Gabès Military Hospital, Gabès, Tunisia
idiopathic pulmonary hemosiderosis (IPH) is an exceptional chronic respiratory disorder of unknown etiology. Its prevalence is estimated at 0.24 to 1.23 cases per million and nearly 80% of the cases manifest before the age of 10. Adult forms are very rare. We describe here the case of pulmonary tuberculosis occurring in adult patient with IPH.
a 20-year-old woman was explored for recurrent hemoptysis, stage II dyspnea and chronic cough. Laboratory tests showed a microcytic and hypochromic hyposideremic anemia without other anomalies. X-rays and chest CT scans showed bilateral and diffuse alveolar-interstitial syndrome. Broncho alveolar lavage was suggesting an intra-alveolar hemorrhage. Systemic disease, vasculitis and severe infections were excluded and the diagnosis of IPH was confirmed by lung biopsy revealing hemosiderin-laden macrophages in the alveoli.
the patient received systemic glucocorticoids with a good and total response. Eight months later she was admitted because of fever, hemoptysis, marked inflammatory syndrome and leucopenia. Chest radiography and tomography were non-contributory. Bronchofibroscopy with direct exam for mycobacterium tuberculosis was positive. Under anti-tubercular therapy, the evolution was favorable.
lung tuberculosis associated to idiopathic pulmonary hemosiderosis is very rare. Immunodeficiency, corticotherapy as well as the underlying pulmonary lesions can support such an association.
1st International Military Congress of Tropical Medicine and Sub-Saharan Diseases ()
Dates: 23 Oct 16 - 25 Oct 16
Contact person: Pr Salem Bouomrani (Salembouomrani@yahoo.fr)