Diagnostic labyrinth: case of late verification of polyorganic tuberculosis on the background of autoimmune hemolytic anemia
https://doi.org/10.54921/2413-0346-2025-13-3-72-76
Abstract
The article presents a complex clinical case of late diagnosis of multiple organ tuberculosis in a 59-year-old female patient with autoimmune hemolytic anemia (AIHA). It delineates a ten-month diagnostic investigation during which the initial symptoms were interpreted by the medical professionals as manifestations of underlying hematological disease, its associated complications, or inefficacy of the antibiotic therapy. The authors highlight low informative value of the immunological tests (ATP test) when utilized in the context of immunosuppression caused by both AIHA and systemic glucocorticoid therapy. An analysis was conducted to identify diagnostic errors and factors contributing to delayed diagnosis. The conclusion drawn from this analysis indicates the need for high phthisiatric vigilance in patients with immunosuppressive conditions and importance of active use of invasive methods of diagnosis verification.
About the Authors
N. L. Karpina
Federal State Budgetary Scientific Institution «Central Research Institute of Tuberculosis»
Россия
Россия
Moscow
A. D. Egorova
Federal State Budgetary Scientific Institution «Central Research Institute of Tuberculosis»
Россия
Россия
Moscow
A. Yu. Borisova
Federal State Budgetary Scientific Institution «Central Research Institute of Tuberculosis»
Россия
Россия
Moscow
O. M. Gordeeva
Federal State Budgetary Scientific Institution «Central Research Institute of Tuberculosis»
Россия
Россия
Moscow
References
1. Васильченкова П.И., Гальцева И.В., Лукина Е.А. Аутоиммунная гемолитическая анемия: современное состояние вопроса // Онкогематология. – 2023. – Т. 18. – № 2. – С. 60-67. DOI: 10.17650/1818-8346-2023-18-2-60-67
2. Гордеева О.М., Карпина Н.Л., Шабалина И.Ю. и др. Мультидисциплинарный подход к диагностике и лечению сочетанной микобактериальной и грибковой инфекции легких у больного с ANCA-ассоциированным системным васкулитом на заместительной почечной терапии. Случай из практики // Нефрология и диализ. – 2020. – Т. 22. – № 4. – С. 546-554. https://doi.org/10.28996/2618-9801-2020-4-546-554
3. Горлова Е.Е. Патология иммунитета при туберкулезе (обзор литературы) // Бюл. физиологии и патологии дыхания. – 2010. – № 35. – С. 37-44.
4. Корсунский И.А., Кудлай Д.А. Диагностика и контроль клеточного иммунитета пациентов с туберкулезом // Тихоокеанский мед. журн. – 2021. – № 2 (84). – С. 19-24. – DOI10.34215/1609-1175-2021-2-19-24
5. Отраслевые и экономические показатели противотуберкулезной работы в 2021–2022 гг. / Нац. мед. исследоват. центр фтизиопульмонологии и инфекц. заболеваний. – М., 2023. – 56 с.
6. Юденко М.А., Буйневич И.В., Рузанов Д.Ю. Внелегочный туберкулез: особенности диагностики // Пробл. здоровья и экологии. – 2023. – Т. 20. – № 1. – С. 48-55. – DOI10.51523/2708-6011.2023-20-1-06
7. Fragoulis G.E., Nikiphorou E., Dey M. et al. 2022 EULAR recommendations for screening and prophylaxis of chronic and opportunistic infections in adults with autoimmune inflammatory rheumatic diseases //Ann. Rheum. Dis. – 2023. – Vol. 82, №6. – P. 742-753. doi: 10.1136/ard-2022-223335
8. Hill A., Hill Q.A. Autoimmune hemolytic anemia // Hematology. Am. Soc.Hematol. Educ. Program. 2018. – 2018. – № 1. – P. 382-389. DOI: 10.1182/asheducation-2018.1.382
9. Rathish D., Siribaddana S. Tuberculosis induced autoimmune haemolyticanaemia: a systematic review to find out common clinical presentations, investigation findings and the treatment options // Allergy Asthma Clin. Immunol. – 2018. – Vol. 14, №11. doi: 10.1186/s13223-018-0236-y.
10. World Health Organization. Global tuberculosis report 2023 / World Health Organization. – Geneva: WHO, 2023.
Review
For citations:
Karpina N.L., Egorova A.D., Borisova A.Yu., Gordeeva O.M. Diagnostic labyrinth: case of late verification of polyorganic tuberculosis on the background of autoimmune hemolytic anemia. Tuberculosis and socially significant diseases. 2025;13(3):72-76. (In Russ.) https://doi.org/10.54921/2413-0346-2025-13-3-72-76
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