Your browser doesn't support javascript.
loading
Miliary tuberculosis: a severe opportunistic infection in juvenile systemic lupus erythematosus patients.
Freire, Priscilla S; Montoni, João D; Ribeiro, Aline S M; Marques, Heloísa H; Mauad, Thais; Silva, Clovis A.
Afiliación
  • Freire PS; Pediatric Rheumatology Unit, Instituto da Criança, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
  • Montoni JD; Pediatric Rheumatology Unit, Instituto da Criança, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
  • Ribeiro AS; Pediatric Rheumatology Unit, Instituto da Criança, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
  • Marques HH; Pediatric Infectious Diseases Unit, Instituto da Criança, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
  • Mauad T; Department of Pathology, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
  • Silva CA; Pediatric Rheumatology Unit, Instituto da Criança, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil; Division of Rheumatology, Instituto da Criança, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil. Electronic address: clovis.silva@icr.usp.br.
Rev Bras Reumatol Engl Ed ; 56(3): 274-9, 2016.
Article en En, Pt | MEDLINE | ID: mdl-27267647
INTRODUCTION: One of the main issues in juvenile systemic lupus erythematosus (JSLE) patients is infection, such as tuberculosis (TB). Of note, SLE patients are susceptible to pulmonary and extrapulmonary TB. However, to our knowledge, this contagious disease was rarely reported in pediatric lupus population, particularly diffuse or miliary TB. Therefore, from January 1983 to December 2011, 5,635 patients were followed-up at our Pediatric Rheumatology Unit and 285 (5%) of them met the American College of Rheumatology classification criteria for SLE. CASE REPORTS: Four (1.4%) of our JSLE patients had disseminated TB and were described herein. All of them were female gender, received BCG vaccination and did not have a history of TB household contact. The median of current age at TB diagnosis and the period between JSLE and TB diagnosis were 17 years old (range 14-20) and 5.5 years (range 2-7), respectively. All patients developed miliary TB during the course of the disease. The median of SLE Disease Activity Index 2000 (SLEDAI-2K) was 4 (2-16) and the patients were treated with immunosuppressive agents (glucocorticoid, azathioprine and/or intravenous cyclophosphamide). Two of them presented sepsis and TB diagnosis was only established at autopsy, especially with lungs, central nervous system and abdominal involvements. Anti-TB therapy (isoniazid, rifampicin and pyrazinamide) was indicated in the other two TB cases, however they deceased. DISCUSSION: Miliary TB is a rare and severe opportunist infection in pediatric lupus population. This study reinforces the importance of routine searches for TB in JSLE patients.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis Miliar / Infecciones Oportunistas / Inmunosupresores / Lupus Eritematoso Sistémico Límite: Adolescent / Child / Female / Humans / Male Idioma: En / Pt Revista: Rev Bras Reumatol Engl Ed Año: 2016 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Brasil
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis Miliar / Infecciones Oportunistas / Inmunosupresores / Lupus Eritematoso Sistémico Límite: Adolescent / Child / Female / Humans / Male Idioma: En / Pt Revista: Rev Bras Reumatol Engl Ed Año: 2016 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Brasil