A case of pulmonary tuberculosis presenting as diffuse alveolar haemorrhage: is there a role for anticardiolipin antibodies?
BACKGROUND
Diffuse alveolar haemorrhage (DAH) has been rarely reported in association with pulmonary infections.


METHODS
We report the case of a 43 year old immunocompetent man presenting with dyspnoea, fever and haemoptysis. Chest imaging showed bilateral ground glass opacities. Microbiological and molecular tests were positive for Mycobacterium tuberculosis and treatment with isoniazid, rifampicin, ethambutol and pyrazinamide was successful. In this case the diagnosis of DAH relies on clinical, radiological and endoscopic findings. Routine blood tests documented the presence of anticardiolipin antibodies. In the reported case the diagnostic criteria of antiphospholipid syndrome were not fulfilled.


CONCLUSIONS
The transient presence of anticardiolipin antibodies in association with an unusual clinical presentation of pulmonary tuberculosis is intriguing although a causal relationship cannot be established.
Marruchella
Almerico
A
Respiratory Endoscopy Unit, National Institute for Infectious Diseases "L, Spallanzani", Via Portuense 292, 00149 Rome, Italy. amarruchella@qubisoft.it
Corpolongo
Angela
A
Tommasi
Chiara
C
Lauria
Francesco N
FN
Narciso
Pasquale
P
D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood*; D000995:Antitubercular Agents / Q000627:therapeutic use; D006470:Hemorrhage / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008168:Lung / Q000473:pathology*; D008297:Male; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification*; D013902:Radiography, Thoracic; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*
D017153:Antibodies, Anticardiolipin; D000995:Antitubercular Agents