Hariz Anis, Guermazi Mouna, Hamdi Mohamed Salah, Boukhris Imen
Universite de Tunis El Manar Faculte de Medecine de Tunis, Tunis, Tunisia.
Internal Medicine, Charles Nicolle Hospital, Tunis, Tunisia.
BMJ Case Rep. 2019 Jun 2;12(6):e229484. doi: 10.1136/bcr-2019-229484.
Although not frequent, thromboembolic events occurring in patient presenting tuberculosis may be observed. Frequency of such thromboembolic events seems correlated with the severity of tuberculosis. We herein report a case of venous thrombosis revealing an asymptomatic tuberculosis. A man aged 32 years was admitted for deep and superficial vein thrombosis of the left arm. Chest CT angiography ruled out pulmonary embolism and showed a mediastinal and pulmonary heterogeneous necrotic mass at the apical segment of the left lung. Histological study of a CT scan-guided pulmonary biopsy showed signs of caseating granuloma compatible with tuberculosis. Diagnosis of venous thrombosis due to pulmonary tuberculosis with lymph nodes involvement was made. Antituberculosis treatment was initiated and required an adjustment of anticoagulant therapy. Our observation highlights the possibility of causative effect between tuberculosis and venous thrombosis.
尽管并不常见，但在患有结核病的患者中可能会观察到血栓栓塞事件。此类血栓栓塞事件的发生率似乎与结核病的严重程度相关。我们在此报告一例静脉血栓形成病例，该病例揭示了无症状性结核病。一名32岁男性因左臂深静脉和浅静脉血栓形成入院。胸部CT血管造影排除了肺栓塞，并显示左肺尖段有纵隔和肺部不均匀坏死性肿块。CT扫描引导下的肺活检组织学研究显示有干酪样肉芽肿迹象，符合结核病表现。诊断为伴有淋巴结受累的肺结核所致静脉血栓形成。开始进行抗结核治疗，并需要调整抗凝治疗。我们的观察结果突出了结核病与静脉血栓形成之间存在因果关系的可能性。
