Table 1 Characteristics of the patients in the previous and current case report studies
From: Concurrent severe pulmonary tuberculosis with Evans syndrome: a case report with literature review
Article | Patient | Presentation | Laboratory findings | Imaging studies | Bacteriology | Treatment | Outcome |
|---|---|---|---|---|---|---|---|
Kim et al. [10] | 52-year-old man with a history of Evans syndrome | Expanding perianal ulcer | Hemoglobin: 11.2 g/dL, hematocrit: 34.6%, white blood count: 6900/μL, platelet: 97,000/μL | Chest X-ray: irregular densities and infiltration in both upper lung fields | Sputum and wound smear: acid-fast bacilli. Culture grew M. tuberculosis | Isoniazid, rifampin, ethambutol, pyrazinamide | Ulcer healed |
Morell et al. [11] | 25-year-old woman | Left axillary lymphadenopathy, thrombopenia | Platelet count changed from 86,000/μL to 7000/μL in 2 days, hemoglobin: 12.5 g/dL, hematocrit: 41%, white blood count: 8500/μL, Positive Coombs test after gamma globulin treatment | Normal chest X-ray and chest/abdominal/pelvic CT scan | Lymph node biopsy confirmed acid-fast bacilli and Mycobacterium tuberculosis | Gamma globulin, Antitubercular quadritherapy | Recovered |
Sharma et al. [12] | 30-year-old woman | Fever, weight loss, petechiae, purpura | Hemoglobin: 48 g/dL, platelet: 5000/μL, positive Coombs test | X-ray/CT: infiltration in bilateral middle lung fields, necrotic mediastinal and mesenteric nodes | Sputum smear revealed acid-fast bacilli | Category 1 antitubercular therapy, hydroxychloroquine, methylprednisolone, and then corticosteroids | Recovered |
Shi et al. [13] | 26-year-old pregnant woman, with a history of Evans syndrome | Cough, fever, dyspnea | Hemoglobin: 101 g/dL, platelet: 73,000/μL, white cell count: 13,860/μL, negative Coombs test | Chest X-ray/CT: diffuse bilateral infiltration and pleural effusion. Abdominal CT splenomegaly | Sputum PCR showed M. tuberculosis | Mechanical ventilation, antituberculosis therapy (isoniazid, rifampin, ethambutol, pyrazinamide, moxifloxacin), methylprednisolone, plasma exchange | Fetal demise, patient recovered |
Gyawali et al. [14] | 20-year-old man | Melena, fever | Hemoglobin: 5.3 g/dL, white blood count: 5400/μL, platelet: 319,000/μL, positive Coombs test | Chest X-ray/CT: multiple centriacinar nodules, right pleural effusion | Sputum negative for acid-fast bacilli | Isoniazid, rifampin, pyrazinamide, ethambutol, prednisone | Increased fatigue, weakness after stopping prednisone, recovered after methylprednisone and cyclosporine |
Current case | 69-year-old woman | Fever, shortness of breath | Hemoglobin: 7.3 g/dL, white blood count: 4900/μL, platelet: 160,000/μL | Chest X-ray/CT: bilateral diffuse patchy infiltration and miliary nodules | Sputum smear result of acid-fast bacilli: 3+ | Isoniazid, rifapentine, sulbactam/cefoperazone | Recovered |