Tuberculosis and phrenic nerve destruction
Date
2007-08
Journal Title
Journal ISSN
Volume Title
Publisher
Health and Medical Publishing Group (HMPG)
Abstract
ENGLISH ABSTRACT: Phrenic nerve palsy (PNP) is often associated with Mycobacterium tuberculosis-related expansile pneumonia, possibly because
of nerve entrapment by healing fibrosis.
Mohan and Jayaswal1 postulated that pressure on the left phrenic nerve by an enlarged hilar lymph node caused unilateral
diaphragmatic paralysis in a 6-year-old boy who developed PNP during the course of pulmonary tuberculosis (PTB). Gie et
al. described 6 childhood cases of PTB complicated by unilateral
PNP. The children did not recover on antituberculosis
drugs and steroids, or in 1 case, after surgical decompression.
Therefore the theory of glandular compression alone does not
adequately account for PNP as a complication of PTB. Our case,
in which the fate of the phrenic nerve was confirmed, provides
strong evidence that destruction of the phrenic nerve by the tuberculous
inflammatory process is involved in the pathogenesis
of diaphragmatic paralysis, which may influence the clinical
management of these children.
Description
Keywords
Phrenic nerve palsy, PNP, Tuberculosis, Phrenic nerve destruction
Citation
Dempers, JJ, Bezuidenhout, J, Schneider, JW & Janse van Rensburg, M 2007, 'Tuberculosis and phrenic nerve destruction', SAMJ, vol. 97, no. 8, pp. 573-573.