Comorbidity: alobar holoprosencephaly and pulmonary tuberculosis in a child (a case report)

Abstract

Aim: to demonstrate the features of detection and management of a child with simultaneous alobar holoprosencephaly and pulmonary tuberculosis (TB) by the example from our own clinical observation. Materials and methods. A clinical case of our own observation of the simultaneous course of pulmonary TB and alobar holoprosencephaly in the child who was treated in the pediatric department of the clinical base of the Department of Phthysiatry and Pulmonology of Zaporizhzhia State Medical and Pharmaceutical University on Public Non-Profit Enterprise “Zaporizhzhia Regional Clinical and Diagnostic Center of Phthysiatry and Pulmonology” of Zaporizhzhia Regional Council. Results. The 4-year-old child diagnosed with pulmonary TB was admitted to the Pediatric Department. Previously, the child was diagnosed with alobar holoprosencephaly in a children’s hospital. His condition was severe due to the main disease. Family members, who had contact with the child, were examined to rule out TB. The index patient was a grandmother, who had recurrent drug-sensitive TB and was looking after the child living apart from the family. The treatment for TB was successful, but the child developed drug-induced hepatotoxicity. Also, the child had episodic convulsions when admitted to the department, which did not repeat after the prescribed treatment by a neurologist. Conclusions. Alobar holoprosencephaly is a severe and rare structural brain abnormality with complex and multifactorial causes. This condition can be identified at the first screening examination of a pregnant woman, so prenatal diagnosis is quite important. The disease leads to severe disability and requires assistance of physicians in different specialties. Treatment for tuberculosis is successful but demands more monitoring of side effects during antimycobacterial therapy.