Pulmonary microangiopathy in patients with diabetes mellitus and tuberculosis

Abstract

Pulmonary biopsy was carried out in 30 patients with type I (insulin-dependent) diabetes mellitus during diagnostic bronchoscopy for pulmonary tuberculosis. Biopsy specimens collected at lung sites distant from the zone of tuberculous involvement were examined by routine histological methods and electron microscopy. Signs of microangiopathies (MAP) were detected in all the cases. These signe were moderate in 12 and extensive in 18 patients. The diabetic origin of MAP was confirmed not only by morphological, but by clinical data as well, namely, direct correlation with the duration and severity of diabetes and the severity of diabetic retinopathy and nephropathy. Pulmonary tuberculosis developing in the presence of manifest pulmonary MAP ran a more grave course and poorly responded to specific chemotherapy.