English

Abstract

A 23 year old male presented with severe autoimmune hemolytic anemia in association with constitutional symptoms suggestive of TB with calcified lesion on X ray chest. A diagnosis of endobronchial TB was confirmed with bronchoscopy and sputum for Ziehl Neelsen stain was positive and the patient responded to antituberculosis treatment. There are few case reports of autoimmune hemolytic anemia with endobronchial TB. KEY WORDSAutoimmune hemolytic anemia, Endobronchial lesion, Tuberculosis. INTRODUCTION: Tuberculosis is usually associated with small degree of hematological abnormalities like iron deficiency anemia, thrombocytopenia, leucopenia, pancytopenia, Leukemoid reaction etc, but hemolytic anemia associated with pulmonary tuberculosis is rare. We report a case of autoimmune hemolytic anemia due to endobronchial pulmonary tuberculosis in a young man. CASE HISTORY: A 23 year old male presented to Pulmonary Medicine department of our hospital with complaints of high grade fever, dry cough , loss of appetite since 1 1/2 month. There was no history of hematologic disorder or blood transfusion and the patient was not on any drugs. He had past history of Antituberculosis treatment 12-13 months back for 6 months. The family history was not significant. On examination temperature was normal, Pulse 100/min, BP100/70 mm of Hg. He had no palpable lymph nodes. Systemic examination of respiratory, cardiovascular and abdomen was normal. Chest x ray showed bilateral old calcified lesions suggestive of old Pulmonary TB. CT scan of thorax showed features of old tubercular infection. USG abdomen showed hepatosplenomegaly. The lab findings were as followsHb5.4 g/dl, PC-2.4lakh/dl, Reticulocyte Count-18.5%, T Bil-4.2mg/dl , Direct Bil-1.8mg/dl,