Volume: 44 Issue: 2
Year: 2024, Page: 236-239, Doi: https://doi.org/10.51248/v44i2.09
Received: April 26, 2024 Accepted: June 11, 2024 Published: Aug. 17, 2024
A 55yr old Graves’ disease female individual on irregular medication presented to our emergency department with complaints of increased generalized weakness and decreased appetite for around 30 days as well as a fever and breathlessness for six days and with many days history of gingival bleeding and petechiae on the abdomen, lower extremities which are recurrent. The initial evaluation led to the diagnosis of Pulmonary Tuberculosis [TB] in the background of graves. Further workup of the patient revealed the presence of Evans syndrome [ES]. Here, we report a case with TB and ES in an established Graves disease patient. Individuals with ES are generally managed with steroids. On the other hand, steroids can cause suppression of immunity, which raises the risk of TB and makes its management tougher. The co-occurrence of TB and ES in a Graves’ disease individual is very rarely reported in the past. This patient was simultaneously effectively managed with prednisolone, carbimazole (in 3 divided doses), and antitubercular therapy [ATT].
Keywords: Immunosuppressive Therapy, Pulmonary Tuberculosis, Evans Syndrome, Graves Disease.
Sohom Ghosh, Chennareddy Vijay, Tanmaya Brahmadarshini Bhuyan, Sonam Samal, Sourav Maiti, Tirumalaraju Veneeth Varma, Anmol Sahoo, Jonnalagadda Vihari. Immunosuppressive Therapy in a Patient with Pulmonary Tuberculosis and Evans Syndrome with Established Graves Disease -- Worth the Risk?. Biomedicine: 2024; 44(2):236-239