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Tuberculosis in children with sickle cell anaemia: a retrospective study in French tertiary care centres

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Abstract

Tuberculosis (TB) and sickle cell anaemia (SCA) may affect the same population of patients, particularly in Africa but also in high-TB incidence areas in developed countries. However, few data are available from children with SCA who develop TB. The aim of this study was to describe the clinical features and outcome of TB diagnosed in children with SCA. We conducted a retrospective, descriptive study in three referral centre of Sickle Cell Disease in Paris, France. We included 11 patients with SCA who develop TB. The median age at TB diagnosis was 11 years [7.5–14.5]. Two patients were asymptomatic and nine patients were symptomatic. Six patients had pulmonary TB (pulmonary, pleural and mediastinal lesions). Five patients had extrapulmonary TB (osteoarticular TB, hepatic TB, cervical and mediastinal TB). Mycobacterium tuberculosis was isolated in four of the 11 cases. All patients recovered after a median of 6 months of anti-TB treatment. The localisation of TB and outcome after treatment in our SCA patients were similar to the one observed in an age-and sex-matched control group of non-SCA patient with TB.

Conclusion: despite the low number of patients included in our study, SCA does not seem to be a risk factor for severe TB.

What is Known:

• Tuberculosis (TB) remains a global health problem particularly in developing countries, and Sickle cell anaemia (SCA) is currently one of the most common genetic diseases in the world that mainly affects African populations.

• Very few data are available on TB in SCA patients.

What is New:

• The features of TB in children with SCA seem to be comparable to those expected in general population, with favourable outcomes in response to standard treatment.

• Monitoring the dosage of anti-TB treatments could be of interest because of the possible impact of SCA on drug metabolism.

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Abbreviations

BCG:

Bacille Calmette–Guerin

CT scan:

Computerized tomography scan

HbS:

Haemoglobin S

HIV:

Human immunodeficiency virus

IGRA:

Interferon gamma release assay

LBTI:

Latent tuberculosis infections

SCA:

Sickle cell anaemia

TB:

Tuberculosis

TST:

Tuberculosis skin test

WHO:

World Health Organization

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Authors and Affiliations

  1. Robert Debré Hospital, F-75019, Paris, France

    Nina Droz, Agathe De Lauzanne, Albert Faye & Berengere Koehl

  2. Pediatric Emergency Department, Louis Mourier Hospital, 178 rue des Renouillet, 92700, Colombes, France

    Nina Droz

  3. Assistance Publique-Hôpitaux de Paris, Hematology Unit, Robert Debré Hospital, F-75019, Paris, France

    Laurent Holvoet, Florence Missud & Malika Benkerrou

  4. Assistance Publique-Hôpitaux de Paris, Reference Centre of Sickle Cell Disease, Robert Debré Hospital, F-75019, Paris, France

    Laurent Holvoet, Florence Missud & Malika Benkerrou

  5. INSERM UMR 1123, ECEVE, Paris, France

    Malika Benkerrou & Albert Faye

  6. Assistance Publique-Hôpitaux de Paris, Reference Centre of Sickle Cell Disease, Necker Hospital, Paris, France

    Valentine Brousse

  7. Assistance Publique-Hôpitaux de Paris, Pediatric Unit, Louis Mourier Hospital, Colombes, France

    Marie-Hélène Odièvre

  8. Université Paris 7 Denis Diderot, Paris Sorbonne Cité, Paris, France

    Albert Faye & Berengere Koehl

Authors
  1. Nina Droz
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  2. Agathe De Lauzanne
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  3. Laurent Holvoet
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  4. Florence Missud
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  5. Malika Benkerrou
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  6. Valentine Brousse
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  7. Marie-Hélène Odièvre
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  8. Albert Faye
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  9. Berengere Koehl
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Contributions

BK and AD conceptualized and designed the study. ND and BK have written the manuscript. AF, BK and AD contributed to the follow-up of patients with tuberculosis. LH, MB and FM contributed to the follow-up of patients with sickle cell disease. CP and MO participated in data collection.

All authors approved of the final manuscript as submitted.

Corresponding author

Correspondence to Nina Droz.

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Funding

No external funding was secured for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Financial disclosure

The authors have no financial relationships relevant to this article to disclose.

Ethical approval

This study was declared to the French National Commission of Data Processing, Files and Individual Liberties and was approved by the local ethics committee at the Robert Debré Hospital in Paris, France (IRB no: 188317v0).

Research involving human participants and/or animals

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Communicated by Communicated by Nicole Ritz

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Droz, N., De Lauzanne, A., Holvoet, L. et al. Tuberculosis in children with sickle cell anaemia: a retrospective study in French tertiary care centres. Eur J Pediatr 176, 723–729 (2017). https://doi.org/10.1007/s00431-017-2905-0

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  • DOI: https://doi.org/10.1007/s00431-017-2905-0

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