Tuberculous Lymphadenitis in a Case of Takayasu’s Arteritis
Narendra AMVR, Srinivasan
VR, Murali Mohan Rao
Nizam’s Institute of Medical Sciences Punjagutta,
23 years old house wife presented to our institute with supraclavicular lymphadenopathy of 8 months associated with pain for 2 weeks before presentation.
On clinical evaluation she had a single lymph node of 2.5 x 2.5 cm. which is firm and slightly tender. She is found to have absent Rt. Radial, branchial pulses and other peripheral are felt normally. Review history after noticing the absent pulse, revealed pain in Rt. Hand suggestive of claudication pain. Her blood pressure is normal. BP is 110/70 (Lt. arm). There is no h/o fever or weight loss.
Her Hb, TC, DC, platelet, ESR were normal. She was found to have positive for mantoux (21mm) and MRA of aortic arch which is done for the evidence of aortoarteritis revealed Rt. subclavian focal stenosis and sub-segmental narrowing of brachial artery (Rt.). Lt. common carotid and Lt. subclavian arteries showed multiple stenosis suggestive of Takayasu’s arteritis. Her lymph node biopsy revealed granulomatous lesion with caseation and grown Mycobacterium tuberculosis .
She has been started on ATT (HREZ) and doing well. Further intervention is planned after completion of ATT. Earlier various theories have been put forward regarding Mycobacterium tuberculosis role in the etiopathogenesis of Takayasu’s arteritis, which is no longer valid. We present an interesting association of TB lymphadenitis with Takayasu’s arteritis, which is incidental.