Oral tuberculosis following autologous bone marrow transplantation for Hodgkin's disease with interleukin-2 and alpha-interferon immunotherapy.
A patient with Hodgkin's disease (HD) underwent autologous bone marrow transplantation (ABMT). Six months later while receiving interleukin (IL)-2 and alpha-interferon immunotherapy, he developed a painful lesion in his oral cavity with a fistula in the buccal area. Excision biopsy disclosed necrotizing granulomatous inflammation with acid-fast bacillus. The patient received a 9-month course of isoniazide, rifampin and pyrazinamide, and recovered. The possible pathophysiological mechanism is discussed.
Toren
A
A
Pediatric Hemato/Oncology Department, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Ackerstein
A
A
Gazit
D
D
Or
R
R
Raveh
D
D
Kupolovicz
U
U
Engelhard
D
D
Nagler
A
A
D000276:Adjuvants, Immunologic / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D003131:Combined Modality Therapy; D004198:Disease Susceptibility; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005402:Fistula / Q000209:etiology; D006689:Hodgkin Disease / Q000150:complications / Q000628:therapy*; D006801:Humans; D016867:Immunocompromised Host; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D007376:Interleukin-2 / Q000009:adverse effects* / Q000627:therapeutic use; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D009894:Opportunistic Infections / Q000209:etiology*; D019226:Oral Ulcer / Q000209:etiology; D011718:Pyrazinamide / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012293:Rifampin / Q000627:therapeutic use; D012307:Risk Factors; D019172:Transplantation Conditioning / Q000009:adverse effects; D014182:Transplantation, Autologous; D014393:Tuberculosis, Oral / Q000188:drug therapy / Q000209:etiology*
D000276:Adjuvants, Immunologic; D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents; D016898:Interferon-alpha; D007376:Interleukin-2; D011994:Recombinant Proteins; D011718:Pyrazinamide; D007538:Isoniazid; D012293:Rifampin