Refractory Autoimmune Hematological Presentations of Undiagnosed Tuberculosis.

Four patients who presented with autoimmune cytopenias as the sole manifestation of undiagnosed tuberculosis are described here. These were refractory to conventional immunosuppressive therapy and responded dramatically to treatment of the infection. The potential association between tuberculosis and immune hematological conditions is highlighted. Literature is reviewed with respect to possible pathogenetic mechanisms. Clinicians need to be aware of this type of unusual presentation of tuberculosis and must consider this chronic bacterial infection as a potential cause for refractory cytopenias.