A CASE OF CONCOMITANT TUBERCULOSIS AND SARCOIDOSIS WITH MYCOBACTERIALDNA PRESENT IN THE SARCOID LESION

A 35-year-old Chinese woman initially presented with histologically an d bacteriologically confirmed tuberculous lymphadenitis. She was also found to have thrombocytopenia, elevated serum alkaline phosphatase, a nd bilateral lung infiltrates. After 15 months of antituberculosis tre atment, despite resolution of the cervical lymphadenopathy, she starte d to experience dyspnea. Chest radiograph appearance, thrombocyte coun t, and liver biochemistry had an deteriorated as well. Histologic find ings from tissues obtained via transbronchial biopsy and open lung bio psy were consistent with sarcoidosis but also showed the presence of m ycobacterial DNA by the polymerase chain reaction. She subsequently ac hieved a very good response clinically radiographically, hematological ly, and biochemically with 1-year of corticosteroid treatment for her sarcoidosis, and she remained relapse-free afterwards. The concomitant presence of tuberculosis and sarcoidosis in this patient together wit h title presence of mycobacterial DNA in the sarcoid lesion reiterate the possibility that mycobacteria or some of its components may be cap able of inducing the immune response and the pathologic changes of sar coidosis.