High risk of tuberculosis in systemic lupus erythematosus?
High risk of tuberculosis in systemic lupus erythematosus?
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DOI：
10.1191/0961203306lu2289xx
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发表时间：
2006-04-01
期刊：
影响因子：
2.6
通讯作者：
Aguirre, C
中科院分区：
文献类型：
--
作者：
Erdozain, JG;Ruiz-Irastorza, G;Aguirre, C
系统性红斑狼疮(SLE)患者中结核病的发病率和严重程度在不同的系列中差异很大。此外，前瞻性数据也很稀缺。这项研究的目的是分析我们的狼疮患者队列中结核病的频率和严重程度。我们分析了232例系统性红斑狼疮患者的前瞻性数据库中的数据(ACR标准)。未定期给予异烟肼预防。我们确定了10年内(1994年1月至2003年12月)诊断的所有结核病病例。分析了以下变量：结核病年发病率、感染部位和对治疗的反应。从已发表的关于SLE患者结核病发病率的系列报道中提取数据，在1603个人年的随访中，3名患者(1.3%)出现了临床表现的结核病，发病率为187例/10万人年(95%可信区间39-547)。在此期间，我区结核病年合并发病率为30/10万。我们记录了两例肺结核和一例结核性胸膜炎。所有患者对治疗均有良好的反应。其他系列SLE患者的年结核病发病率在土耳其的150/10万患者和印度的2450/10万患者之间变化，这些患者大多来自发展中国家。值得注意的是，在大多数情况下，肺外形式的高流行率以及与结核病相关的死亡率上升。我们没有看到任何播散性感染的病例，所有患者对治疗都有良好的反应。我们的数据与高度流行地区的数据相比，在发病率、严重性和结果方面都更有利。
The incidence and severity of tuberculosis ( TB) in patients with systemic lupus erythematosus (SLE) varies greatly among different series. In addition, prospective data are scarce. The aim of this study is to analyse the frequency and severity of TB in our cohort of lupus patients. We analysed data from a prospective database of a single center cohort of 232 patients with SLE (ACR criteria). Prophylaxis with isoniazid was not regularly administered. We identified all cases of TB diagnosed during 10 years ( January 1994 to December 2003). The following variables were analysed: annual incidence of TB, location of infection and response to therapy. Data from published series reporting on the incidence of TB among SLE patients were extracted.Three patients (1.3%) suffered clinically manifest TB in 1603 patient-years of follow-up, resulting in an incidence of 187 cases/100 000 patient-years (95% CI 39 - 547). The pooled annual incidence of TB infection in our area during this period was 30/100 000 individuals. We recorded two cases of pulmonary TB and one case of tuberculous pleurisy. All patients had good response to therapy. The annual incidence of TB among SLE patients in other series, most of them from developing countries, varied between 150/100 000 patients in Turkey and 2450/100 000 patients in India. Of note, high prevalence of extrapulmonary forms as well as elevated TB-associated mortality was reported in most series.TB was more frequent in SLE patients than expected in the general population. We did not see any cases of disseminated infection and all patients had good response to treatment. Our data compare favourably in terms of incidence, severity and outcome with those from highly endemic areas.