Detection of Tuberculous Lymphadenopathy by Positron Emission Tomography/Computed Tomo­graphy in a Patient with Behçet’s Disease

Cho, Suhyun; Lee, Kyung Jong; Lee, Jong Doo; Bang, Dongsik; Cho, Sung Bin

doi:10.2340/00015555-1079

Cited by 6 publications

(2 citation statements)

References 5 publications

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“…Tuberculosis and BD may have a common genetic background, and BD by itself may produce a defect in cell-mediated immunity, which increases the individual's susceptibility to tuberculosis [1] . Secondly, tuberculosis may play a key role in exacerbating BD, since there is evidence of infectious agents (including M. tuberculosis) triggering BD in patients with genetic susceptibility [2] . Furthermore, there is a condition known as pseudo-Behçet's that can mimic BD, consisting of hypersensitivity reactions to M. tuberculosis, such as reactive arthritis and erythema nodosum (Poncet's disease) and orogenital ulcers (as a result of cross-reactivity between microorganism antigens and mucosal proteins) [3] .…”

Section: Discussionmentioning

confidence: 99%

Behçet’s Disease and Tuberculosis: A Complex Relationship

Freitas

Marques

Grilo

et al. 2020

European Journal of Case Reports in Internal Medicine

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Behçet’s disease (BD) is a systemic vasculitis characterized by recurrent orogenital ulceration and several systemic manifestations (such as gastrointestinal involvement, vascular disease or arthritis). The pathogenesis is still unknown but the trigger role of certain pathogens such as Mycobacterium tuberculosis is well documented. Furthermore, patients with BD are more susceptible to tuberculosis due to immunity defects. Here, we describe the case of a 70-year-old woman with a history of recurrent oral aphthae and inflammatory arthritis presenting with extensive thrombosis of left upper limb major veins, a positive HLA B51 genotype and colon ulceration; hence, BD diagnosis was made after excluding other causes. Simultaneously, the patient had cutaneous abscesses not associated with immunosuppressive therapy with continuous development, and after recurrent negative tuberculosis work-up, M. tuberculosis was isolated in an abscess culture.

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Section: Discussionmentioning

confidence: 99%

Behçet’s Disease and Tuberculosis: A Complex Relationship

Freitas

Marques

Grilo

et al. 2020

European Journal of Case Reports in Internal Medicine

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“…After the postoperative administration of anti-TB medication for 6 months, the occurrence of "pseudo-BD" may be associated with the pathological effects of TB in the patient. Another method of identification is based on the interferon-γ release assay (IGRA), which may help assess the probability of TB in BD patients (21). After analyzing 173 pure BD patients and 59 BD patients with TB infection, the sensitivity and specificity of IGRA were 88.9% and 74.8%, respectively, and the optimal cutoff for diagnosing active TB was 70/106 spot-forming cells, which improved the diagnostic efficiency of BD patients with active TB (22).…”

Section: Association Between Tb and Bechet's Diseasementioning

confidence: 99%

Primary adrenal tuberculosis infection in patients with Behcet’s disease presenting as isolated adrenal metastasis by 18F-FDG PET/CT: a rare case report and literature review

Teng¹,

Fan²,

Wang³

et al. 2021

Gland Surg

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Primary adrenal tuberculosis (TB) is a rare type of extrapulmonary tuberculosis (EPTB).A pathological biopsy is usually required to make a definite diagnosis due to nonspecific symptoms.Antituberculous chemotherapy is the main treatment regimen, and cortisol replacement therapy should be added when adrenal insufficiency is involved. Here, we present a 59-year-old man who had recurrence of oral and genital aphthosis for 3 years and was diagnosed with Behcet's disease (BD), which was cured by thalidomide. After 10 days of admission, the patient had sudden abdominal pain in the right upper quadrant with high fever and was diagnosed with acute cholecystitis attack, which was treated by percutaneous transhepatic gallbladder drainage (PTGBD). Further contrast-enhanced CT showed a right adrenal mass with a diameter of 2.0 cm, and PET-CT indicated intense 18 F-fluorodeoxyglucose ( 18 F-FDG) uptake in the right adrenal mass with a maximum standardized uptake value (SUV max ) of 15.2. As a metastatic adrenal mass was suspected, the patient underwent retroperitoneal laparoscopic adrenalectomy. Histopathological and immunohistochemical analysis revealed primary adrenal TB. After routine anti-tuberculosis treatment with isoniazid, rifampin, pyrazinamide and ethambutol for six months, the patient was cured and discharged. In summary, primary unilateral adrenal TB without adrenal insufficiency is difficult to diagnose only on the basis of clinical manifestations and examinations. Further studies are needed to develop an easier and more accurate diagnostic examination.

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Uveitis developing in tuberculous lymphadenitis‐associated Behçet's disease during anti‐tuberculosis therapy

Takahashi

Otomo

Kawakami

et al. 2020

Respirology Case Reports

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Behçet's disease (BD) is thought to be elicited by triggers such as tuberculosis (TB) infection in individuals with genetically aberrant immune activity, although the exact pathogenesis remains unknown. Seven cases of BD thought to be triggered by TB have been reported to date. In all cases, Behçet's symptoms improved smoothly after starting TB treatment. We present the first report of uveitis developing two months after starting TB treatment in a 46‐year‐old woman with tuberculous lymphadenitis presenting with oral and genital ulcers and erythema nodosum‐like lesions on diagnosis of TB. The appearance of uveitis was attributed to a paradoxical reaction in TB because of simultaneous relapse of lymphadenopathy and retinal findings on fluorescein angiography. Although rare, physicians should be aware that ocular involvement can occur during anti‐TB therapy, most likely with extrapulmonary TB, because ocular involvement may decrease patient quality of life if visual symptoms become irreversible with delayed diagnosis and treatment.

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Detection of Tuberculous Lymphadenopathy by Positron Emission Tomography/Computed Tomography in a Patient with Behçet’s Disease

Cited by 6 publications

References 5 publications

Behçet’s Disease and Tuberculosis: A Complex Relationship

Behçet’s Disease and Tuberculosis: A Complex Relationship

Primary adrenal tuberculosis infection in patients with Behcet’s disease presenting as isolated adrenal metastasis by 18F-FDG PET/CT: a rare case report and literature review

Uveitis developing in tuberculous lymphadenitis‐associated Behçet's disease during anti‐tuberculosis therapy

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Detection of Tuberculous Lymphadenopathy by Positron Emission Tomography/Computed Tomo­graphy in a Patient with Behçet’s Disease

Cited by 6 publications

References 5 publications

Behçet’s Disease and Tuberculosis: A Complex Relationship

Behçet’s Disease and Tuberculosis: A Complex Relationship

Primary adrenal tuberculosis infection in patients with Behcet’s disease presenting as isolated adrenal metastasis by 18F-FDG PET/CT: a rare case report and literature review

Uveitis developing in tuberculous lymphadenitis‐associated Behçet's disease during anti‐tuberculosis therapy

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Detection of Tuberculous Lymphadenopathy by Positron Emission Tomography/Computed Tomography in a Patient with Behçet’s Disease