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Tuberculosis infection in patients with systemic lupus erythematosus: pulmonary and extra-pulmonary infection compared

Clinical Rheumatology volume 27, pages 557–563 (2008)Cite this article

Abstract

Systemic lupus erythematosus (SLE) patients had an increased susceptibility to tuberculosis (TB). The aim of this study was to investigate the prevalence and clinical characteristics of TB in SLE patients, with focus on the differences between pulmonary and extra-pulmonary TB. This is a retrospective study that reviewed the medical records of 3,179 SLE patients from 1985 to 2004. The diagnosis of TB was confirmed by one of the following: positive acid-fast bacillus (AFB) smear, positive culture of Mycobacterium tuberculosis from appropriate specimens, or a histopathologic finding of caseating granuloma on specimen. During the 20-year review period, TB was documented in 19 SLE patients, with 21 episodes. Ten of 21 episodes (47.6%) were pulmonary TB while the other 11 episodes (52.4%) were extra-pulmonary TB. Among extra-pulmonary TB, there were joint and cutaneous involvements in five, miliary in two, Pott’s disease in two, peritoneum in one, and spleen in one. The most common manifestations of TB were fever and cough. Delayed diagnosis and adverse effects of anti-TB therapy were observed in the extra-pulmonary TB group. While SLE patients commonly present with prolonged fever or chronic cough, tuberculosis infection should be taken into consideration.

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Affiliations

  1. Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Chih-Lung Hou, Yi-Chan Tsai, Li-Chen Chen & Jing-Long Huang

  2. Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Children’s Hospital, 5, Fu-Hsin St., Kueishan, Taoyuan, Taiwan

    Chih-Lung Hou, Yi-Chan Tsai, Li-Chen Chen & Jing-Long Huang

  3. Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung University, Taoyuan, Taiwan

    Chih-Lung Hou, Yi-Chan Tsai, Li-Chen Chen & Jing-Long Huang

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  1. Chih-Lung Hou
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  2. Yi-Chan Tsai
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  3. Li-Chen Chen
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  4. Jing-Long Huang
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Correspondence to Jing-Long Huang.

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Hou, CL., Tsai, YC., Chen, LC. et al. Tuberculosis infection in patients with systemic lupus erythematosus: pulmonary and extra-pulmonary infection compared. Clin Rheumatol 27, 557–563 (2008). https://doi.org/10.1007/s10067-007-0741-8

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  • DOI: https://doi.org/10.1007/s10067-007-0741-8

Keywords

  • Extra-pulmonary tuberculosis
  • Pulmonary tuberculosis
  • Systemic lupus erythematosus