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Introduction <p>Tuberculosis (TB) is a major global health burden, causing over one million deaths annually. Chronic inflammation in TB promotes a hypercoagulable state, increasing the risk of thromboembolic events.</p> Clinical Presentation <p>We report a case series of four adult male patients with microbiologically confirmed TB who developed thromboembolic events at diverse sites, including the portal vein, pulmonary arteries, cerebral venous sinuses, and deep veins of the lower limbs. Thrombosis occurred both at presentation and after initiation of antitubercular therapy. None of the patients had conventional thrombotic risk factors or inherited thrombophilia. All were managed with antitubercular therapy and apixaban under close monitoring.</p> Conclusion <p>TB can predispose patients to thrombosis, including at uncommon sites such as cerebral venous sinuses and the portal vein. Early recognition is critical to prevent complications. Non-vitamin K antagonists oral anticoagulants (NOACs) were effective in this series; however, caution is warranted when coadministered with rifampicin, and larger studies are required to determine optimal anticoagulation strategies.</p>

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Thrombosis and Active Tuberculosis: A Case Series of Four Patients with Review of the Literature

  • 期刊论文

  • 发表日期：

    2026年3月27日

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  • Kunal Kumar,
  • Neeraj Sharma,
  • Priyanka Singh,
  • Amit Singh Vasan,
  • Robin Choudhary,
  • Sandeep Rana,
  • Varun Anand

摘要

Introduction

Tuberculosis (TB) is a major global health burden, causing over one million deaths annually. Chronic inflammation in TB promotes a hypercoagulable state, increasing the risk of thromboembolic events.

Clinical Presentation

We report a case series of four adult male patients with microbiologically confirmed TB who developed thromboembolic events at diverse sites, including the portal vein, pulmonary arteries, cerebral venous sinuses, and deep veins of the lower limbs. Thrombosis occurred both at presentation and after initiation of antitubercular therapy. None of the patients had conventional thrombotic risk factors or inherited thrombophilia. All were managed with antitubercular therapy and apixaban under close monitoring.

Conclusion

TB can predispose patients to thrombosis, including at uncommon sites such as cerebral venous sinuses and the portal vein. Early recognition is critical to prevent complications. Non-vitamin K antagonists oral anticoagulants (NOACs) were effective in this series; however, caution is warranted when coadministered with rifampicin, and larger studies are required to determine optimal anticoagulation strategies.