Necrotizing granuloma predisposed by AIDS?

[JBlue]

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I just did a qbank question that showed a granuloma in the lung and asked what disease predisposed the infection. The answer was AIDS. I can see that AIDS can predispose you to TB but I thought that patients with AIDS wouldn't be able to form granulomas because of their low Th cell count. Can anyone clarify this for me?

 

[Idiopathic]

Goljans statement about your T cells being so low that you wont get a granuloma is fairly correct, but one way to look at this might be in a more general way: i.e., the disease is TB, and what predisposes someone to TB, NOT NECESSARILY to granuloma formation. The answer there is definitely AIDS.

 

[JBlue]

Thanks. That is kind of what I thought after the fact. I just couldn't get past the AIDS=no granuloma formation but after I read it again and saw that it was referring to the disease, not the granuloma, it made sense.

 

[remedios]

Did the answer say AIDS specifically, or only HIV?

Cauz HIV positive can certainly predispose you to TB even when not at AIDS stage, and in that case you can totally have granulomas.

edit: I guess TB is considered an AIDS defining illness, though my impression is that even HIV patients with adequate amount of CD4 count are more vulnerable to TB, and I would argue (without any evidence to back me up, of course) that the CD4 count is correlated with ability to form granulomas.

 

[Idiopathic]

I dont believe the CDC considers HIV a risk factor for TB. AIDS definitely is.

 

[JBlue]

Did the answer say AIDS specifically, or only HIV?

Cauz HIV positive can certainly predispose you to TB even when not at AIDS stage, and in that case you can totally have granulomas.

Yep. The question said AIDS specifically. I checked that too thinking that with HIV you could still form granulomas. It was a qbank question.

 

[remedios]

I dont believe the CDC considers HIV a risk factor for TB. AIDS definitely is.

From Emedicine:

Race: In the United States, two thirds of TB cases occur among minorities. The risk to people who are indigent is 300 times higher than the national risk (Slutkin, 1986); the risk for persons with HIV is 200-400 times greater. Other high-risk populations include hospital employees, inner-city residents, nursing home residents, persons with alcoholism, persons who use illicit drugs, and prisoners.

I didn't search the CDC website. I think it would be confusing though if only AIDS is considered a risk factor, as TB is definitely an AIDS defining illness.

 

[Idiopathic]

From Emedicine:

Race: In the United States, two thirds of TB cases occur among minorities. The risk to people who are indigent is 300 times higher than the national risk (Slutkin, 1986); the risk for persons with HIV is 200-400 times greater. Other high-risk populations include hospital employees, inner-city residents, nursing home residents, persons with alcoholism, persons who use illicit drugs, and prisoners.

I didn't search the CDC website. I think it would be confusing though if only AIDS is considered a risk factor, as TB is definitely an AIDS defining illness.

good work