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[Tuberculosis in a cohort of patients with systemic lupus erythematosus]. / Tuberculosis en una cohorte de pacientes con lupus eritematoso sistémico.
González León, Rocío; Garrido Rasco, Rocío; Chinchilla Palomares, Eduardo; García Hernández, Francisco José; Castillo Palma, M Jesús; Sánchez Román, Julio.
Afiliación
  • González León R; Unidad de Colagenosis e Hipertensión Pulmonar, Servicio de Medicina Interna, Hospital Universitario Virgen del Rocío, Sevilla, España.
Reumatol Clin ; 6(5): 256-61, 2010.
Article en Es | MEDLINE | ID: mdl-21794726
ABSTRACT

OBJECTIVES:

1) To study tuberculosis (TB) infection in a cohort of patients with systemic lupus erythematosus (SLE) and to compare its frequency and characteristics with that of others series. 2) To look for differential characteristic among SLE patients with and without TB. 3) To investigate if there was any relationship between TB's most severe forms and higher doses of glucocorticoids (GC) or other immunosuppressants. PATIENTS AND

METHOD:

Retrospective review of medical records of 789 SLE patients and description of the clinical characteristics of 13 cases of active TB infection among them. Bibliographical search in MEDLINE-PubMed of the SLE/TB series published, using the terms infection, tuberculosis, systemic lupus erythematosus. Comparative study of clinical, biological and therapeutic differences between cases (SLE/TB+) and controls (SLE/TB) using χ(2) and Fisher exact test.

RESULTS:

Thirteen patients with active tuberculosis were detected (10 women, average age 36 years/SD 11,2/prevalence 1,6%). Nine (69,2%) of them were primary infections and 4 (30,8%) reactivations. Microbiological diagnosis (smear examination for acid-fast bacilli and/or culture on Lowestein-Jensen medium) was established in 11 patients (84,6%). TB Pulmonary manifestations was present in 9 patients (69,2%) and extra-pulmonary manifestations were found in 8 [(61,5%); 6 of them (46%) were disseminated forms]. Nine (69,2%) patients were on GC therapy at the moment TB was diagnosed. Four of the TB patients died (30,8%). Myositis was more frequent in TB cases (p < 0,05). This data is similar to that reported in the literature.

CONCLUSIONS:

In our series, TB mortality was high (30,8%) in a patients with SLE. Frequency of extrapulmonary forms was double than that described in the Spanish population. Patients with higher GC dose had more severe forms of TB.

Texto completo: 1 Banco de datos: MEDLINE Tipo de estudio: Risk_factors_studies Idioma: Es Año: 2010 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Tipo de estudio: Risk_factors_studies Idioma: Es Año: 2010 Tipo del documento: Article