ABSTRACT
Scleroderma is a chronic systemic autoimmune disease of unknown origin characterized by excessive collagen deposition and autoantibodies. Patients with autoimmune diseases are known to develop infections like tuberculosis due to the disease per se and also secondary to immunosuppressive treatment. Mycobacterial infections are also known to induce the development of autoantibodies. We present a case of simultaneous occurrence of interstitial lung disease and pulmonary tuberculosis (BAL positive for AFB) in a patient with features of systemic sclerosis. Antibody profile was done were found to be positive for ANA. She also had most of the classical features of scleroderma on clinical examination thus confirming the diagnosis. A detailed history, clinical examination, radiological examination, bronchoscopy and immunological test helped in the diagnosis of the patient. We highlight the importance of suspicion, careful general examination, radiological assessment and screening tuberculosis patients for autoantibody profile in presence of a multisystem involvement.
ABSTRACT
Background: Tuberculosis is one of the leading causes of death due to infectious Disease worldwide, with an estimated 8.9 million new cases and 1.6 million Deaths worldwide. Aim: To study the type and degree of pulmonary impairment in treated pulmonary Tuberculosis patients using spirometry. To co -relate present symptoms and radiological findings and to assess the degree of impairment. For identification of impairment (obstructive, restrictive or mixed) that contribute to long term disability and decreased quality of life. Materials and methods: Retrospective observational study was done in Meenakshi Medical College Hospital. A total of 75 treated pulmonary tuberculosis patients were taken for study with clinical data, chest x-ray pattern, smoking and biomass fuel exposure history were recorded. Their pulmonary function was assessed using spirometry. Results: All patients were symptomatic and most common symptom was breathlessness. Chest radiograph showing 1 or 2 zones involved patients were 40 (53.3%) and more than 3 zones involved were 35 (46.7%).Most of the patients 51 (68%) showed a Restrictive pattern in spirometry, 10 (13.3%) showed an obstructive pattern and 14 (18.7%) showed a mixed pattern. Smoking and Biomass fuel exposure did not show a significant co-relation with spirometry pattern but initial sputum positive patients and defaulter patients showed a significant co-relation with spirometry pattern. Conclusion: The most common pulmonary impairment pattern in treated pulmonary tuberculosis patients was Restrictive pattern. Hence pulmonary tuberculosis need follow up even after treatment for early detection and treatment for their pulmonary disability
ABSTRACT
Granulomatosis with Polyangiitis (GPA) is a rare multisystem autoimmune disease. It is characterized histopathologically by necrotizing granulomatous vasculitis. The classical clinical triad consists of upper airway involvement (characterized by sinusitis, otitis, nasal mucosa ulcers, bone deformities, and subglottic stenosis), lower respiratory tract involvement (cough, chest pain, hemoptysis) and glomerulonephritis. We reported here a case of Wegener’s granulomatosis presenting as a thick walled cavity.