Associations between selected immune-mediated diseases and tuberculosis: record-linkage studies.
BMC Med
; 11: 97, 2013 Apr 04.
Article
de En
| MEDLINE
| ID: mdl-23557090
ABSTRACT
BACKGROUND:
Previous studies have suggested that there may be an association between some immune-mediated diseases and risk of tuberculosis (TB).METHODS:
We analyzed a database of linked statistical records of hospital admissions and death certificates for the whole of England (1999 to 2011), and a similar database (the Oxford Record Linkage Study (ORLS)) for a region of southern England in an earlier period. Rate ratios for TB were determined, comparing immune-mediated disease cohorts with comparison cohorts.RESULTS:
In the all-England dataset, there were significantly elevated risks of TB after hospital admission for the following individual immune-mediated diseases Addison's disease, ankylosing spondylitis, autoimmune hemolytic anemia, chronic active hepatitis, coeliac disease, Crohn's disease, dermatomyositis, Goodpasture's syndrome, Hashimoto's thyroiditis, idiopathic thrombocytopenia purpura (ITP), myasthenia gravis, myxedema, pemphigoid, pernicious anemia, polyarteritis nodosa, polymyositis, primary biliary cirrhosis, psoriasis, rheumatoid arthritis, scleroderma, Sjögren's syndrome, systemic lupus erythematosus (SLE), thyrotoxicosis and ulcerative colitis. Particularly high levels of risk were found for Addison's disease (rate ratio (RR) = 11.9 (95% CI 9.5 to 14.7)), Goodpasture's syndrome (RR = 10.8 (95% CI 4.0 to 23.5)), SLE (RR = 9.4 (95% CI 7.9 to 11.1)), polymyositis (RR = 8.0 (95% CI 4.9 to 12.2)), polyarteritis nodosa (RR = 6.7 (95% CI 3.2 to 12.4)), dermatomyositis (RR = 6.6 (95% CI 3.0 to 12.5)), scleroderma (RR = 6.1 (95% CI 4.4 to 8.2)) and autoimmune hemolytic anemia (RR = 5.1 (95% CI 3.4 to 7.4)).CONCLUSIONS:
These two databases show that patients with some immune-mediated diseases have an increased risk of TB, although we cannot explicitly state the direction of risk or exclude confounding. Further study of these associations is warranted, and these findings may aid TB screening, control and treatment policies.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Tuberculose
/
Maladies du système immunitaire
Type d'étude:
Etiology_studies
/
Risk_factors_studies
Limites:
Female
/
Humans
/
Male
Pays/Région comme sujet:
Europa
Langue:
En
Journal:
BMC Med
Sujet du journal:
MEDICINA
Année:
2013
Type de document:
Article
Pays d'affiliation:
Royaume-Uni