Tuberculous Lymphadenitis in a Case of Takayasu’s
Arteritis
Narendra AMVR, Srinivasan
VR, Murali Mohan Rao
Vuda,
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been put forward regarding Mycobacterium tuberculosis role in the etiopathogenesis of Takayasu’s arteritis, which is no longer valid.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.