A Case of Sarcoidosis Who Developed (a complication) Pulmonary Tuberculosis One Year after the Diagnosis of the Disease

Abstract

A 72-year-old woman was pointed out to have mediastinal lymphadenopathy in 1997. She was admitted to our hospital on March 1998 for an evaluation of lymphadenopathy. The diagnosis of sarcoidosis was established by the findings of epithelioid cell granulomas in TBLB specimen, increased percentage of lymphocytes (40%, CD4/CD8 5.7) in BALF, negative culture for tubercle bacilli in BALF, high level of serum ACE, and coincidence of uveitis.
One year after the initial diagnosis of sarcoidosis, she began to have a low-grade fever and was admitted to our hospital again on March 1999. Ziehl-Neelsen staining of the induced sputum revealed Mycobacterium tuberculosis and positive result was also obtained in PCR examination of mycobacterium DNA in the gasric fluid and then we started antituberculosis chemotherapy.
In this case we speculate that mycobacterial infection occurred secondary to sarcoidosis. From this case we would like to emphasize that enough attention should be paid to a complication of tuberculosis in sarcoidosis patients.