Diagnostic challenge of tuberculosis in systemic lupus erythematosus: a case report and literature review.
Rheumatol Int
; 43(11): 2131-2139, 2023 11.
Article
em En
| MEDLINE
| ID: mdl-37522958
ABSTRACT
Patients with systemic lupus erythematosus (SLE) are at increased risk of tuberculosis (TB) infection due to immune dysfunction and immunosuppressive therapy. We present a case study of a 40-year-old woman with systemic lupus erythematosus (SLE). Initially, she was diagnosed with a lupus flare based on her clinical symptoms and laboratory results. However, upon further investigation, positive polymerase-chain reaction results for M. tuberculosis in the cerebrospinal fluid and lung parenchymal changes on chest computed tomography scan were indicative of TB infection. There was initial uncertainty regarding whether TB had triggered a flare-up of SLE or if TB was merely mimicking the symptoms of a SLE flare-up. However, as increasing the prednisolone dose did not have a positive effect and the patient's condition improved significantly with anti-TB treatment alone, it became clearer that the deterioration observed upon admission was primarily due to TB progression rather than an SLE flare-up. Additionally, we review the current literature on TB and SLE, including risk factors, diagnostic challenges, and treatment considerations, highlighting the importance of considering TB infection in patients with SLE who present with overlapping manifestations. Prompt diagnosis and treatment are essential for improving outcomes in these patients.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Tuberculose
/
Lúpus Eritematoso Sistêmico
/
Mycobacterium tuberculosis
Tipo de estudo:
Diagnostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
Idioma:
En
Revista:
Rheumatol Int
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Ucrânia