Simultaneous Occurrence of Hodgkin Disease & TB: 3 Cases
Simultaneous Occurrence of Hodgkin Disease & TB: 3 Cases
Tuberculosis (TB) has been described in association with malignancies including Hodgkin disease (HD). We report three cases of simultaneous occurrence of TB and HD. In two of these cases clinical symptoms improved after TB treatment was instituted and before HD was diagnosed. Fever recurrence in one case and persistence of mediastinal lymphadenopathy in the other, however, prompted consideration of an additional diagnosis. Interestingly, in one these two patients, both TB and HD diagnosis were obtained from the same lymph node. Since both diseases share many symptoms and signs, physicians faced with initial therapeutic failure when caring for HD and TB patients should be aware of the possibility of the simultaneous occurrence of both diseases.
Tuberculosis (TB) has been extensively described in association with various malignancies, especially Hodgkin disease (HD). This association is known to occur at rates that are almost always greater than those encountered in the general population. The overlap of symptoms of TB and HD may lead to misdiagnosis, causing the late recognition of either one of these diseases. Furthermore, the introduction of immunosuppressive chemotherapy together with the immunologic changes already present in patients with HD may worsen the clinical course of TB, should this disease not be promptly recognized and adequately treated. We report here three instances of simultaneous HD and TB infection, all three occuring within a period of six months in the city of Sao Paulo, the largest Brazilian metropolitan area.
Tuberculosis (TB) has been described in association with malignancies including Hodgkin disease (HD). We report three cases of simultaneous occurrence of TB and HD. In two of these cases clinical symptoms improved after TB treatment was instituted and before HD was diagnosed. Fever recurrence in one case and persistence of mediastinal lymphadenopathy in the other, however, prompted consideration of an additional diagnosis. Interestingly, in one these two patients, both TB and HD diagnosis were obtained from the same lymph node. Since both diseases share many symptoms and signs, physicians faced with initial therapeutic failure when caring for HD and TB patients should be aware of the possibility of the simultaneous occurrence of both diseases.
Tuberculosis (TB) has been extensively described in association with various malignancies, especially Hodgkin disease (HD). This association is known to occur at rates that are almost always greater than those encountered in the general population. The overlap of symptoms of TB and HD may lead to misdiagnosis, causing the late recognition of either one of these diseases. Furthermore, the introduction of immunosuppressive chemotherapy together with the immunologic changes already present in patients with HD may worsen the clinical course of TB, should this disease not be promptly recognized and adequately treated. We report here three instances of simultaneous HD and TB infection, all three occuring within a period of six months in the city of Sao Paulo, the largest Brazilian metropolitan area.
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