Challenging differential diagnosis, Rare disease
Wojciech J. Piotrowski, Paweł Górski, Joanna Duda-Szymańska, Sylwia Kwiatkowska
Department of Pneumology and Allergy, Medical University of Łódź, Łódź, Poland
Am J Case Rep 2014; 15:216-220
Sarcoidosis is a granulomatous inflammatory disease that is induced by unknown antigen(s) in a genetically susceptible host. Although the direct link between Mycobacterium tuberculosis (MTB) infection and sarcoidosis can be excluded on the basis of a current knowledge, the non-infectious mechanisms may explain the causative role of mycobacterial antigens. The co-incidence of tuberculosis (TB) and sarcoidosis, and higher incidence of mycobacterial DNA in biological samples of sarcoid patients, have been reported by many authors.
Case Report: We present a case in which MTB infection in 1 family member triggered a sarcoid reaction in the infected subject and 2 other non-infected family members. We discuss different aspects of diagnosis and differentiation, as well as up-to-date hypotheses on the possible mechanisms leading to sarcoid inflammation in patients exposed to MTB.
Conclusions: This case series documents the possibility of familial spreading of sarcoidosis, and points to MTB as a potential etiological factor.
Keywords: Tuberculosis, Mycobacterium tuberculosis, sarcoidosis