Mycobacterium tuberculosis as a sarcoid factor? A case report of family sarcoidosis

Abstract

Patient: Male, 26Final Diagnosis: SarcoidosisSymptoms: Disseminated lung parenchymal changesMedication: —Clinical Procedure: —Specialty: PulmonologyObjective:Rare diseaseBackground:Sarcoidosis is a granulomatous inflammatory disease that is induced by unknown antigen(s) in a genetically susceptible host. Although the direct link between Mycobacterium tuberculosis (MTB) infection and sarcoidosis can be excluded on the basis of a current knowledge, the non-infectious mechanisms may explain the causative role of mycobacterial antigens. The co-incidence of tuberculosis (TB) and sarcoidosis, and higher incidence of mycobacterial DNA in biological samples of sarcoid patients, have been reported by many authors.Case Report:We present a case in which MTB infection in 1 family member triggered a sarcoid reaction in the infected subject and 2 other non-infected family members. We discuss different aspects of diagnosis and differentiation, as well as up-to-date hypotheses on the possible mechanisms leading to sarcoid inflammation in patients exposed to MTB.Conclusions:This case series documents the possibility of familial spreading of sarcoidosis, and points to MTB as a potential etiological factor.

Immunological Evidence for the Role of Mycobacteria in Sarcoidosis: A Meta-Analysis

“…Indeed, some factors do favor the involvement of mycobacteria in sarcoidosis, including the following: (1) histopathological appearances of the granulomas; (2) an immune response to M . tuberculosis antigens in sarcoidosis patients; (3) development of mycobacterial disease either coincidentally, before or after development of sarcoidosis [ 35 – 37 ]; (4) the detection of mycobacteria from samples of patients with sarcoidosis by PCR [ 26 , 27 ]; and (5) acid-fast cell wall-deficient forms (CWDF) of bacteria can be grown from the blood of patients with sarcoidosis [ 38 , 39 ]. It is important to note that mycobacterial (TB or NTM) antigens and not the active mycobacteria may play roles in the pathogenesis of sarcoidosis.…”

High throughput 16SrRNA gene sequencing reveals the correlation between Propionibacterium acnes and sarcoidosis

“…In addition to propionibacteria, mycobacteria [ 7 , 8 , 27 , 28 ], Borrelia [ 29 , 30 ], mycoplasma [ 31 ], and chlamydia [ 32 ] have also been investigated as pathogenic organisms. Thus, we examined the four microorganisms.…”

“…Molecular biological approaches have been used to search bacterial genome in sarcoidosis lesions [ 33 ]. Previous studies have shown that possible pathogenic organisms for sarcoidosis include propionibacteria [ 8 , 33 , 34 ], mycobacterium [ 7 , 8 , 27 , 28 ], borrelia [ 29 , 30 ], mycoplasma [ 31 ], and chlamydia [ 32 ]. Particularly, MTB and propionibacteria are the most frequently reported bacteria correlating with sarcoidosis [ 35 , 36 ].…”

“…In spite of the efforts, no consistent and definitive conclusion has been drawn. Piotrowski et al reported that MTB infection triggered a sarcoid reaction, and thus they proposed that TB and sarcoidosis might be different clinical manifestations of MTB infection [ 28 ]. However, our previous study, which determined the copy number of MTB in lymph node specimens of patients with TB or sarcoidosis, suggests that MTB may not be the pathogenic bacterium of sarcoidosis [ 8 ].…”

QuantiFERON-TB-GOLD In-Tube in Patients with Sarcoidosis

“…Sarcoidosis and tuberculosis (TB) are the diseases that share many similarities responsible for difficulties in differential diagnosis. Mycobacterium tuberculosis (MTB) antigens have been suspected to induce sarcoidosis [1], and the coexistence of both entities seems to be possible [2]. The recent molecular studies have also revealed that the diseases have similar blood transcriptional signature [3,4].…”