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Aitnasser K, Nakkabi I, Amrani HN. Diffuse reversed halo sign in an immunocompetent patient. Radiol Case Rep 2024; 19:1055-1059. [PMID: 38226052 PMCID: PMC10788371 DOI: 10.1016/j.radcr.2023.09.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/22/2023] [Accepted: 09/25/2023] [Indexed: 01/17/2024] Open
Abstract
The reversed halo sign (RHS) is a specific radiological image observed mostly on computed tomography (CT) scans as a focal round area of ground-glass attenuation surrounded by a crescent or ring of consolidation. It is common to many entities of respiratory diseases and can be found in both infectious, noninfectious inflammatory pathologies and some malignant tumors, including invasive pulmonary fungal infection, tuberculosis (TB), community-acquired pneumonia, granulomatosis, sarcoidosis. It is also seen in pulmonary neoplasms and infarction, and following radiation and radiofrequency. We report the case of an immunocompetent 54-year-old North African male patient, initially hospitalized for chronic cough associated with dysphonia and general symptoms such as weight loss, fever, and night sweats. Radiological exploration surprisingly confirmed the presence of RHS, tuberculosis was confirmed by a postbronchoscopy positive sputum Xpert MTB/RIF essay tuberculosis after we started antibacillary treatment, and the evolution was spectacular with regression of the lesions. The objective of this report is to increase knowledge about RHS and its pathological correlation with TB. Since it is not specific to any disorder, it is important to explore its finding in a clinical and epidemiological manner, especially in endemic countries where the prevalence of tuberculosis is still high.
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Affiliation(s)
- K. Aitnasser
- Pneumo-Phthisiology Department, Souss Massa University Hospital Center, Agadir, Morocco
- Medical and Pharmacological Faculty, Ibn Zohr University, Agadir, Morocco
| | - I. Nakkabi
- Medical and Pharmacological Faculty, Ibn Zohr University, Agadir, Morocco
- ENT and Cervico-Facial Surgery Department, Oued Eddahab Military Hospital, Agadir, Morocco
| | - H. Naji Amrani
- Pneumo-Phthisiology Department, Oued Eddahab Military Hospital, Agadir, Morocco
- Medical and Pharmacological Faculty, Sidi Mohammed Benabdellah University, Fes, Morocco
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Grant AV, Sabri A, Abid A, Abderrahmani Rhorfi I, Benkirane M, Souhi H, Naji Amrani H, Alaoui-Tahiri K, Gharbaoui Y, Lazrak F, Sentissi I, Manessouri M, Belkheiri S, Zaid S, Bouraqadi A, El Amraoui N, Hakam M, Belkadi A, Orlova M, Boland A, Deswarte C, Amar L, Bustamante J, Boisson-Dupuis S, Casanova JL, Schurr E, El Baghdadi J, Abel L. A genome-wide association study of pulmonary tuberculosis in Morocco. Hum Genet 2016; 135:299-307. [PMID: 26767831 DOI: 10.1007/s00439-016-1633-2] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 01/04/2016] [Indexed: 01/04/2023]
Abstract
Although epidemiological evidence suggests a human genetic basis of pulmonary tuberculosis (PTB) susceptibility, the identification of specific genes and alleles influencing PTB risk has proven to be difficult. Previous genome-wide association (GWA) studies have identified only three novel loci with modest effect sizes in sub-Saharan African and Russian populations. We performed a GWA study of 550,352 autosomal SNPs in a family-based discovery Moroccan sample (on the full population and on the subset with PTB diagnosis at <25 years), which identified 143 SNPs with p < 1 × 10(-4). The replication study in an independent case/control sample identified four SNPs displaying a p < 0.01 implicating the same risk allele. In the combined sample including 556 PTB subjects and 650 controls these four SNPs showed suggestive association (2 × 10(-6) < p < 4 × 10(-5)): rs358793 and rs17590261 were intergenic, while rs6786408 and rs916943 were located in introns of FOXP1 and AGMO, respectively. Both genes are involved in the function of macrophages, which are the site of latency and reactivation of Mycobacterium tuberculosis. The most significant finding (p = 2 × 10(-6)) was obtained for the AGMO SNP in an early (<25 years) age-at-onset subset, confirming the importance of considering age-at-onset to decipher the genetic basis of PTB. Although only suggestive, these findings highlight several avenues for future research in the human genetics of PTB.
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Affiliation(s)
- A V Grant
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, 75015, Paris, France, EU
- Paris Descartes University, Imagine Institute, 75015, Paris, France, EU
| | - A Sabri
- Genetics Unit, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco
- Faculty of Sciences-Kenitra, Ibn Tofail University, Kenitra, Morocco
| | - A Abid
- Department of Pneumology, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco
| | - I Abderrahmani Rhorfi
- Department of Pneumology, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco
| | - M Benkirane
- Blood Transfusion Center, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco
| | - H Souhi
- Department of Pneumology, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco
| | - H Naji Amrani
- Department of Pneumology, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco
| | - K Alaoui-Tahiri
- Department of Pneumology, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco
| | - Y Gharbaoui
- Department of Pneumology, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco
| | - F Lazrak
- Centre de Diagnostic de la tuberculose et des Maladies Respiratoires [CDTMR], Salé, Morocco
| | - I Sentissi
- Centre de Diagnostic de la tuberculose et des Maladies Respiratoires [CDTMR], Salé, Morocco
| | - M Manessouri
- Centre de Diagnostic de la tuberculose et des Maladies Respiratoires [CDTMR], Salé, Morocco
| | - S Belkheiri
- Centre de Diagnostic de la tuberculose et des Maladies Respiratoires [CDTMR], Salé, Morocco
| | - S Zaid
- Centre de Diagnostic de la tuberculose et des Maladies Respiratoires [CDTMR], Salé, Morocco
| | - A Bouraqadi
- Centre de Diagnostic de la tuberculose et des Maladies Respiratoires [CDTMR], Salé, Morocco
| | - N El Amraoui
- National Blood Transfusion Center, Rabat, Morocco
| | - M Hakam
- National Blood Transfusion Center, Rabat, Morocco
| | - A Belkadi
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, 75015, Paris, France, EU
- Paris Descartes University, Imagine Institute, 75015, Paris, France, EU
| | - M Orlova
- McGill Centre for the Study of Host Resistance, The Research Institute of the McGill University Health Centre, Montreal, PQ H3G 1A4, Canada
| | - A Boland
- CEA, Institut de Génomique, Centre National de Génotypage, 91000, Evry, France, EU
| | - C Deswarte
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, 75015, Paris, France, EU
- Paris Descartes University, Imagine Institute, 75015, Paris, France, EU
| | - L Amar
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, 75015, Paris, France, EU
- Paris Descartes University, Imagine Institute, 75015, Paris, France, EU
| | - J Bustamante
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, 75015, Paris, France, EU
- Paris Descartes University, Imagine Institute, 75015, Paris, France, EU
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, 10065, New York, NY, USA
| | - S Boisson-Dupuis
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, 75015, Paris, France, EU
- Paris Descartes University, Imagine Institute, 75015, Paris, France, EU
- Center for the Study of Primary Immunodeficiencies, AP-HP, Necker hospital, 75015, Paris, France, EU
| | - J L Casanova
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, 75015, Paris, France, EU
- Paris Descartes University, Imagine Institute, 75015, Paris, France, EU
- Center for the Study of Primary Immunodeficiencies, AP-HP, Necker hospital, 75015, Paris, France, EU
- Howard Hughes Medical Institute, New York, NY, USA
- Pediatric Hematology-Immunology Unit, AP-HP, Necker Hospital, 75015, Paris, France, EU
| | - E Schurr
- McGill Centre for the Study of Host Resistance, The Research Institute of the McGill University Health Centre, Montreal, PQ H3G 1A4, Canada
| | - J El Baghdadi
- Genetics Unit, Military Hospital Mohammed V, Hay Riad, 10100, Rabat, Morocco.
| | - L Abel
- Laboratory of Human Genetics of Infectious Diseases, Necker Branch, Institut National de la Santé et de la Recherche Médicale U1163, 75015, Paris, France, EU.
- Paris Descartes University, Imagine Institute, 75015, Paris, France, EU.
- St. Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, The Rockefeller University, 10065, New York, NY, USA.
- Human Genetics of Infectious Diseases, INSERM, Université Paris Descartes, Unit 1163, Imagine Institute, 24 Bd du Montparnasse, 75105, Paris, France.
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