MILIARY TUBERCULOSIS PRESENTING AS PANCYTOPENIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2013, Vol 2, Issue 44
Abstract
Miliary tuberculosis results from hematogenous dissemination of tubercle bacilli. It can present in acute, subacute or chronic form. There are many haematological states associated with tuberculosis especially military TB. Haematological abnormalities like anaemia, leucopenia, monocytosis and thrombocytopenia due to tuberculosis are common, but pancytopenia is rare. Pancytopenia can occur due to various reasons like hypersplenism, histiocytic hyperplasia, bone marrow infiltration by granuloma through interferons etc. Tuberculosis is still a major public health problem in developing countries (1). Acute generalized miliary TB is a condition that results from the sudden and often overwhelming hematogenous dissemination of tubercle bacilli from an established focus to many organs of the body. The large number of small , acute tubercles that develops in these organs have been said to resemble millet seeds in size and appearance , hence stems the adjective “miliary”(2). The term miliary was coined in 1700 by John Jacobus Manget, who likened the appearance of the involved lung, with its surface covered with firm white nodules to millet seeds. The clinical presentation of TB is highly variable, manifestations can be acute but more likely subacute or chronic. Acute disease may be fulminant presenting as syndrome of septic shock and acute respiratory distress syndrome (3). The subacute or chronic presentation of miliary TB are more common than acute. These patients may present with fever of unknown origin or dysfunction of one or more organ. Apart from these , there are many haematological states associated with tuberculosis especially military TB. The majority of patients have little disturbance in their hematology other than normochromic or hypochromic anemia, normocytic anaemia of chronic disease (4). Hematological abnormalities like anaemia, leucopenia, leucocytosis, monocytosis and thrombocytopenia due to tuberculosis are common, but bleeding as a presenting manifestation due to tuberculosis is rare (5). There are occasional reports of pancytopenia in miliary TB (6).
Authors and Affiliations
Hardeep Deep , Jasleen Kohli
Keywords
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