Pulmonary thromboembolism in AIDS patient with chronic venous insufficiency, pulmonary tuberculosis and breast cancer: a case report and pathophysiology review.
Recent literature reports thrombotic episodes occurring in patients with HIV infection associated with other abnormalities including neoplasms and infections predisposing to a hypercoagulable state. We report a 47-year-old woman who developed pulmonary thromboembolism in association with HIV infection, pulmonary tuberculosis and breast cancer. She was treated with rifampin, isoniazid, pyrazinamide; heparin, phenprocoumon, zidovudine, lamivudine and efavirenz. Acid fast bacilli were visualized in a sputum smear and three months after, Mycobacterium tuberculosis was isolated from lymph node biopsy during a episode of immune reconstitution. The isolated mycobacteria showed sensitivity to all first-line drugs. HIV infection, breast cancer and pulmonary tuberculosis have several mechanisms that induce hypercoagulable state and can lead to thromboembolic complications. Pulmonary thromboembolism in this patient was a diagnostic challenge because of all the other severe diseases that she experienced at the same time.
Cortez-Escalante
Juan José
JJ
Universidade de Brasília, DF Caixa Postal 04517, 70904-970 Brasília, DF, Brazil. jcorteze@unb.br
Castro
Cleudson
C
Romero
Gustavo Adolfo Sierra
GA
Matos
Luiza
L
Saif
Muhammad Wasif
MW
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000188:drug therapy; D001943:Breast Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy