Tuberculous trochanteritis following hepatic sarcoidosis

Introduction:  Sarcoidosis and tuberculosis are two chronic inflammatory granulomatosis considered to be at the extremes of the same continuum, with clinical manifestations varying according to the individual's immunological response. They may exist independently, together, or sequentially i.e., tuberculosis followed by sarcoidosis or the reverse. Several risk factors can be responsible for this latter sequence, with the most well-known being the use of corticosteroids and Immunosuppressants. This report focuses on TB developing after SR treatment, specifically a case of tuberculous trochanteritis following hepatic sarcoidosis, treated with corticosteroids and methotrexate in an endemic area.   Case report: We report the case of a 37-year-old Moroccan woman diagnosed with hepatic sarcoidosis on the basis of clinical, biological, radiological and histopathological evidence. She was treated with long-term prednisone and methotrexate. 12 years later, the patient developed infectious coxofemoral arthritis, revealing tuberculous trochanteritis on biological and histopathological grounds. Conclusion: The risk of developing tuberculosis after sarcoidosis is low, but influenced by tuberculosis endemicity, sarcoidosis pathophysiological mechanisms and treatment methods. Although this risk often appears later, it should not be neglected, and may lead us to suggest screening of latent tuberculosis infection (LTI) and ongoing clinical and biological monitoring to control its occurrence. Effective management strategies are essential to treat both conditions.