Mediastinal nodal tuberculosis presenting as immune thrombocytopenia

Talbot, S.; Dowling, A.; Dowling, John P.; Fuller, Andrew; Schwarz, M. A.

doi:10.1111/j.1445-5994.1998.tb02084.x

Cited by 17 publications

(13 citation statements)

References 6 publications

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“…Megakaryocytes in the BM, however, increased throughout disease progression. Increased numbers and sizes of megakaryocytes are associated with thrombocytopenia purpura in TB patients with a compensatory response to the premature destruction of platelets by immune targeting [49,50]. Analyses of BM changes in experimental models of TB have been conducted, and a mechanism involving GM-CSF as mediating the increased production of megakaryocytes has been postulated [25].…”

Section: Discussionmentioning

confidence: 98%

Differential polarization of alveolar macrophages and bone marrow-derived monocytes following chemically and pathogen-induced chronic lung inflammation

Redente

Higgins

Dwyer‐Nield

et al. 2010

Journal of Leukocyte Biology

103

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Alveolar macrophages and BDMCs undergo sequential biochemical changes during the chronic inflammatory response to chemically induced lung carcinogenesis in mice. Herein, we examine two chronic lung inflammation models-repeated exposure to BHT and infection with Mycobacterium tuberculosis-to establish whether similar macrophage phenotype changes occur in non-neoplastic pulmonary disease. Exposure to BHT or M. tuberculosis results in pulmonary inflammation characterized by an influx of macrophages, followed by systemic effects on the BM and other organs. In both models, pulmonary IFN-gamma and IL-4 production coincided with altered polarization of alveolar macrophages. Soon after BHT administration or M. tuberculosis infection, IFN-gamma content in BALF increased, and BAL macrophages became classically (M1) polarized, as characterized by increased expression of iNOS. As inflammation progressed in both models, the amount of BALF IFN-gamma content and BAL macrophage iNOS expression decreased, and BALF IL-4 content and macrophage arginase I expression rose, indicating alternative/M2 polarization. Macrophages present in M. tuberculosis-induced granulomas remained M1-polarized, implying that these two pulmonary macrophage populations, alveolar and granuloma-associated, are exposed to different activating cytokines. BDMCs from BHT-treated mice displayed polarization profiles similar to alveolar macrophages, but BDMCs in M. tuberculosis-infected mice did not become polarized. Thus, only alveolar macrophages in these two models of chronic lung disease exhibit a similar progression of polarization changes; polarization of BDMCs was specific to BHT-induced pulmonary inflammation, and polarization of granuloma macrophages was specific to the M. tuberculosis infection.

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Section: Discussionmentioning

confidence: 98%

Differential polarization of alveolar macrophages and bone marrow-derived monocytes following chemically and pathogen-induced chronic lung inflammation

Redente

Higgins

Dwyer‐Nield

et al. 2010

Journal of Leukocyte Biology

103

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“…17 Mediastinal tubercular lymphadenitis in association with ITP has so far been described in case reports in adults. 2,3 The present case report is the first case report describing mediastinal tubercular lymphadenitis in association with ITP in the pediatric age group.…”

Section: Discussionmentioning

confidence: 93%

“…To the best of our knowledge, there are 16 case reports in the literature, which have described 25 cases of tuberculosis associated with immune thrombocytopenia. [1][2][3][5][6][7][8][9][10][11][12][13][14][15][16][17] However, out of these, an overwhelming majority (22 cases) have been described in adults. [1][2][3][5][6][7][8][9][10][11][12][13][14][15] There is a paucity of literature regarding this association in the pediatric population.…”

Section: Discussionmentioning

confidence: 99%

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Immune thrombocytopenic purpura as a presentation of childhood tuberculosis

Krishnamurthy

Yadav

2007

Indian J Pediatr

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Immune thrombocytopenic purpura as a presentation of childhood tuberculosis is a rare event and occasional reports are described in the pediatric literature. We describe a 8-yr-old girl with mediastinal tubercular lymphadenitis-induced immune thrombocytopenia, who was successfully treated with anti-tubercular drugs. We also review the published reports. Tuberculosis should be considered a cause of immune thrombocytopenia in areas where tuberculosis is highly endemic.

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“…The immune basis of tuberculosis-induced thrombocytopenia in these case reports is supported by the presence of either the platelet antigen-specific antibodies or platelet surface membrane IgG [8, 10], or by response to immunomodulatory therapy [3, 6]. The pathogenesis of tuberculosis causing immune thrombocytopenia is thought to be the generation of antiplatelet antibodies by lymphocytes borne as a result of clonal proliferation due to host's immune response to the tuberculous pathogen [10].…”

Section: Discussionmentioning

confidence: 99%

Immune Thrombocytopenia in a Challenging Case of Disseminated Tuberculosis: A Case Report and Review of the Literature

Kalra

Kalra²,

Palaniswamy

et al. 2010

Case Reports in Medicine

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Mycobacterium tuberculosis (MTB) continues to predominate the cause of morbidity, and mortality in the developing world. The disease affects all the organ systems, and presents in various pathologic disease states. We report an uncommon manifestation of this rather common infectious disease in a 19-year-old male. Immune-mediated thrombocytopenia occurring as a consequence of the tuberculosis infection itself is an exceedingly rare occurrence, and at the time of writing of this paper, only 15 such published reports exist in the English literature so far.

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Mediastinal nodal tuberculosis presenting as immune thrombocytopenia

Cited by 17 publications

References 6 publications

Differential polarization of alveolar macrophages and bone marrow-derived monocytes following chemically and pathogen-induced chronic lung inflammation

Differential polarization of alveolar macrophages and bone marrow-derived monocytes following chemically and pathogen-induced chronic lung inflammation

Immune thrombocytopenic purpura as a presentation of childhood tuberculosis

Immune Thrombocytopenia in a Challenging Case of Disseminated Tuberculosis: A Case Report and Review of the Literature

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