Pulmonary tuberculosis presenting with aortic pseudoaneurysm, diffuse alveolar hemorrhage, and cardiomyopathy: Is there an intriguing relationship?  

作　　者：Min Shen Xuejun Zeng Xingrong Liu Bao Liu Baotong Zhou Xue Lin Ran Tian 

机构地区：[1]Department of Cardiac Surgery, PUMCH, CAMS & PUMC, Beijing, China [2]Department of Cardiology, PUMCH, CAMS & PUMC, Beijing, China [3]Department of General Internal Medicine, PUMCH, CAMS & PUMC, Beijing, China [4]Department of Infectious Diseases, PUMCH, CAMS & PUMC, Beijing, China [5]Department of Rheumatology, Peking Union Medical College Hospital (PUMCH), Chinese Academy of Medical Sciences (CAMS) & Peking Union Medical College (PUMC), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China [6]Department of Vascular Surgery, PUMCH, CAMS & PUMC, Beijing, China

出　　处：《Case Reports in Clinical Medicine》2013年第9期495-498,共4页临床医学病理报告（英文）

摘　　要：A 22-year-old Chinese man presented with fever, cough, hoarseness, neck pain, acute heart failure and hemoptysis. Pulmonary tuberculosis was proved by sputum culture. Chest imaging showed an aortic arch pseudoaneurysm and bilateral ground glass opacities. Echocardiography confirmed cardiomyopathy. With anti-TB drugs, high-dose prednisone and surgery, the life of this patient was successfully prolonged for more than four months. The concomitant disorders of aortic pseudoaneurysm, alveolar hemorrhage and cardiomyopathy in pulmonary tuberculosis are intriguing. We postulate that immune-mediated small vessel vasculitis triggered by pathogens plays an important role in the pathogenesis of this disease, rather than a direct TB infection.A 22-year-old Chinese man presented with fever, cough, hoarseness, neck pain, acute heart failure and hemoptysis. Pulmonary tuberculosis was proved by sputum culture. Chest imaging showed an aortic arch pseudoaneurysm and bilateral ground glass opacities. Echocardiography confirmed cardiomyopathy. With anti-TB drugs, high-dose prednisone and surgery, the life of this patient was successfully prolonged for more than four months. The concomitant disorders of aortic pseudoaneurysm, alveolar hemorrhage and cardiomyopathy in pulmonary tuberculosis are intriguing. We postulate that immune-mediated small vessel vasculitis triggered by pathogens plays an important role in the pathogenesis of this disease, rather than a direct TB infection.

关 键 词：PSEUDOANEURYSM VASCULITIS THORACIC AORTA 

分 类 号：R5[医药卫生—内科学]