IVF patient's cough leads to TB, autoimmune diagnosis
pleural effusion
cryobiopsy
pulmonary tuberculosis
anti-tubercular treatment
Women undergoing IVF treatment are at higher risk for tuberculosis. Therefore, an autoimmune evaluation should be part of infertility assessments before starting IVF
–Dr Divya Shree J, Manipal Hospital Jayanagar
Nanditha, a 38-year-old woman, is undergoingto become a mother. After her last embryo pickup was unsuccessful, she visited the hospital for a different reason. For the past three weeks, she had been dealing with a cough, chest pain, shortness of breath, and loss of appetite.Dr Divya Shree J, Consultant – Interventional Pulmonology at Manipal Hospital, Jayanagar, said the patient was found to have a right-sided, which is a fluid build up between the lungs and the chest wall. Nanditha was admitted on April 18, 2025, for further evaluation. A CECT (Contrast-Enhanced Computed Tomography) of the thorax confirmed the presence of fluid, and around 800 ml to 1 litre was drained for analysis.Although tuberculosis (TB) was suspected, initial fluid tests did not confirm the diagnosis. To get more clarity, the medical team performed a rigid bronchoscopy followed by a, a relatively advanced procedure to collect lung tissue.'Cryobiopsy isn't widely used but gives more accurate diagnostic results,' explained Dr Divya Shree. 'In Nanditha's case, the procedure was successful, and we confirmed she had. She was started on(ATT), and her symptoms began to improve within two weeks.'Alongside TB treatment, doctors also examined potential causes of her infertility. Despite having no thyroid or hormonal issues, an autoimmune workup revealed that she tested positive for antinuclear antibodies (ANA). She was diagnosed with an undifferentiated connective tissue disease, a condition that may have contributed to both her infertility and susceptibility to TB.A rheumatologist has advised immunosuppressive therapy, but it will commence only after her infection is fully under control. Dr Divya Shree emphasised the importance of autoimmune screening for women undergoing IVF, as they may be at higher risk for infections like TB.Nanditha was discharged on April 23 and is currently under close follow-up for both conditions.
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