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Lung Disease Associated with Rheumatoid Arthritis pp 165–174Cite as

Mycobacterium Infections in Rheumatoid Arthritis (Tuberculosis and Nontuberculous Mycobacteriosis)

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Abstract

Biological agents have had a tremendous effect in the management of rheumatoid arthritis (RA). However, subsequent infection is regarded as an emerging problem owing to the suppression of host immunity by these agents. Cellular immunity with T lymphocytes plays a crucial role in host defense against mycobacterial infections; hence, immunosuppression due to these biological agents may lead to tuberculosis (TB) and nontuberculous mycobacteria (NTM) infections. Therefore, pretreatment screening for TB and NTM infection and appropriate management are crucial. In general, the lungs are the major site of infection caused by mycobacteria, and the disease may typically have a chronic course. Thus, persistent respiratory symptoms and signs trigger suspicion of pulmonary TB or NTM infection, and chest radiography as well as sputum examination plays a major role in the diagnosis. In addition, promising diagnostic tools such as interferon-gamma release assay (IGRA), anti-MAC antibody measurement, and Xpert MTB/rifampin (RIF) assay are newly available. Further research is needed to verify these assays. As a rule, to avoid development of drug-resistant strains, treatment with multiple drugs for a relatively extensive duration is required for therapy.

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References

  1. Tanoue LT. Pulmonary manifestations of rheumatoid arthritis. Clin Chest Med. 1998;19(4):667–85, viii.

    Article  CAS  PubMed  Google Scholar 

  2. Amital A, Shitrit D, Adir Y. The lung in rheumatoid arthritis. Presse Med. 2011;40(1 Pt 2):e31–48.

    PubMed  Google Scholar 

  3. Massey H, Darby M, Edey A. Thoracic complications of rheumatoid disease. Clin Radiol. 2013;68(3):293–301.

    Article  CAS  PubMed  Google Scholar 

  4. Pai M, Behr MA, Dowdy D, et al. Tuberculosis. Nat Rev Dis Primers. 2016;2:16076.

    Article  PubMed  Google Scholar 

  5. Gideon HP, Flynn JL. Latent tuberculosis: what the host “sees”? Immunol Res. 2011;50(2–3):202–12.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Getahun H, Matteelli A, Abubakar I, et al. Management of latent Mycobacterium tuberculosis infection: WHO guidelines for low tuberculosis burden countries. Eur Respir J. 2015;46(6):1563–76.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Carmona L, Hernandez-Garcia C, Vadillo C, et al. Increased risk of tuberculosis in patients with rheumatoid arthritis. J Rheumatol. 2003;30(7):1436–9.

    PubMed  Google Scholar 

  8. Askling J, Fored CM, Brandt L, et al. Risk and case characteristics of tuberculosis in rheumatoid arthritis associated with tumor necrosis factor antagonists in Sweden. Arthritis Rheum. 2005;52(7):1986–92.

    Article  CAS  PubMed  Google Scholar 

  9. Arkema EV, Jonsson J, Baecklund E, et al. Are patients with rheumatoid arthritis still at an increased risk of tuberculosis and what is the role of biological treatments? Ann Rheum Dis. 2015;74(6):1212–7.

    Article  CAS  PubMed  Google Scholar 

  10. Gardam MA, Keystone EC, Menzies R, et al. Anti-tumour necrosis factor agents and tuberculosis risk: mechanisms of action and clinical management. Lancet Infect Dis. 2003;3(3):148–55.

    Article  CAS  PubMed  Google Scholar 

  11. Ehlers S. Role of tumour necrosis factor (TNF) in host defence against tuberculosis: implications for immunotherapies targeting TNF. Ann Rheum Dis. 2003;62(Suppl 2):ii37–42.

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Lewinsohn DM, Leonard MK, LoBue PA, et al. Official American Thoracic Society/Infectious Diseases Society of America/Centers for Disease Control and Prevention Clinical Practice guidelines: diagnosis of tuberculosis in adults and children. Clin Infect Dis. 2017;64(2):111–5.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Geng E, Kreiswirth B, Burzynski J, et al. Clinical and radiographic correlates of primary and reactivation tuberculosis: a molecular epidemiology study. JAMA. 2005;293(22):2740–5.

    Article  CAS  PubMed  Google Scholar 

  14. Restrepo CS, Katre R, Mumbower A. Imaging manifestations of thoracic tuberculosis. Radiol Clin N Am. 2016;54(3):453–73.

    Article  PubMed  Google Scholar 

  15. Maartens G, Willcox PA, Benatar SR. Miliary tuberculosis: rapid diagnosis, hematologic abnormalities, and outcome in 109 treated adults. Am J Med. 1990;89(3):291–6.

    Article  CAS  PubMed  Google Scholar 

  16. Optican RJ, Ost A, Ravin CE. High-resolution computed tomography in the diagnosis of miliary tuberculosis. Chest. 1992;102(3):941–3.

    Article  CAS  PubMed  Google Scholar 

  17. Boehme CC, Nicol MP, Nabeta P, et al. Feasibility, diagnostic accuracy, and effectiveness of decentralised use of the Xpert MTB/RIF test for diagnosis of tuberculosis and multidrug resistance: a multicentre implementation study. Lancet. 2011;377(9776):1495–505.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Lein AD, Von Reyn CF. In vitro cellular and cytokine responses to mycobacterial antigens: application to diagnosis of tuberculosis infection and assessment of response to mycobacterial vaccines. Am J Med Sci. 1997;313(6):364–71.

    CAS  PubMed  Google Scholar 

  19. Nahid P, Dorman SE, Alipanah N, et al. Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice guidelines: treatment of drug-susceptible tuberculosis. Clin Infect Dis. 2016;63(7):e147–95.

    Article  PubMed  Google Scholar 

  20. Horsburgh CR Jr, Rubin EJ. Clinical practice. Latent tuberculosis infection in the United States. N Engl J Med. 2011;364(15):1441–8.

    Article  CAS  PubMed  Google Scholar 

  21. Sterling TR, Villarino ME, Borisov AS, et al. Three months of rifapentine and isoniazid for latent tuberculosis infection. N Engl J Med. 2011;365(23):2155–66.

    Article  CAS  PubMed  Google Scholar 

  22. Yeh JJ, Wang YC, Sung FC, et al. Rheumatoid arthritis increases the risk of nontuberculosis mycobacterial disease and active pulmonary tuberculosis. PLoS One. 2014;9(10):e110922.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Brode SK, Jamieson FB, Ng R, et al. Risk of mycobacterial infections associated with rheumatoid arthritis in Ontario, Canada. Chest. 2014;146(3):563–72.

    Article  PubMed  Google Scholar 

  24. Winthrop KL, Baxter R, Liu L, et al. Mycobacterial diseases and antitumour necrosis factor therapy in USA. Ann Rheum Dis. 2013;72(1):37–42.

    Article  CAS  PubMed  Google Scholar 

  25. Griffith DE, Aksamit T, Brown-Elliott BA, et al. An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007;175(4):367–416.

    Article  CAS  PubMed  Google Scholar 

  26. Moore EH. Atypical mycobacterial infection in the lung: CT appearance. Radiology. 1993;187(3):777–82.

    Article  CAS  PubMed  Google Scholar 

  27. Hayashi M, Takayanagi N, Kanauchi T, et al. Prognostic factors of 634 HIV-negative patients with Mycobacterium Avium Complex lung disease. Am J Respir Crit Care Med. 2012;185(5):575–83.

    Article  CAS  PubMed  Google Scholar 

  28. Levin DL. Radiology of pulmonary Mycobacterium Avium-Intracellulare Complex. Clin Chest Med. 2002;23(3):603–12.

    Article  PubMed  Google Scholar 

  29. Koh WJ, Lee KS, Kwon OJ, et al. Bilateral bronchiectasis and bronchiolitis at thin-section CT: diagnostic implications in nontuberculous mycobacterial pulmonary infection. Radiology. 2005;235(1):282–8.

    Article  PubMed  Google Scholar 

  30. Christensen EE, Dietz GW, Ahn CH, et al. Initial roentgenographic manifestations of pulmonary Mycobacterium tuberculosis, M kansasii, and M intracellularis infections. Chest. 1981;80(2):132–6.

    Article  CAS  PubMed  Google Scholar 

  31. Woodring JH, Vandiviere HM. Pulmonary disease caused by nontuberculous mycobacteria. J Thorac Imaging. 1990;5(2):64–76.

    Article  CAS  PubMed  Google Scholar 

  32. Kitada S, Kobayashi K, Ichiyama S, et al. Serodiagnosis of Mycobacterium Avium-Complex pulmonary disease using an enzyme immunoassay kit. Am J Respir Crit Care Med. 2008;177(7):793–7.

    Article  CAS  PubMed  Google Scholar 

  33. Institute CaLS. Susceptibility testing of Mycobacteria, Nocardiae and other aerobic Actinomycetes: Clinical and Laboratory Standards Institute; 2011.

    Google Scholar 

  34. Wallace RJ Jr, Brown BA, Griffith DE, et al. Initial clarithromycin monotherapy for Mycobacterium Avium-Intracellulare Complex lung disease. Am J Respir Crit Care Med. 1994;149(5):1335–41.

    Article  PubMed  Google Scholar 

  35. Wallace RJ Jr, Brown BA, Griffith DE. Drug intolerance to high-dose clarithromycin among elderly patients. Diagn Microbiol Infect Dis. 1993;16(3):215–21.

    Article  PubMed  Google Scholar 

  36. Guidelines for chemotherapy of pulmonary nontuberculous mycobacterial disease—2012 revised version. Kekkaku. 2013;88(1):29–32.

    Google Scholar 

  37. Management of opportunist mycobacterial infections: Joint Tuberculosis Committee Guidelines 1999. Subcommittee of the Joint Tuberculosis Committee of the British Thoracic Society. Thorax. 2000;55(3):210–8.

    Google Scholar 

  38. Wallace RJ Jr, Brown BA, Griffith DE, et al. Clarithromycin regimens for pulmonary Mycobacterium Avium Complex. The first 50 patients. Am J Respir Crit Care Med. 1996;153(6 Pt 1):1766–72.

    Article  PubMed  Google Scholar 

  39. Dautzenberg B, Piperno D, Diot P, et al. Clarithromycin in the treatment of Mycobacterium Avium lung infections in patients without AIDS. Clarithromycin Study Group of France. Chest. 1995;107(4):1035–40.

    Article  CAS  PubMed  Google Scholar 

  40. Griffith DE, Brown BA, Cegielski P, et al. Early results (at 6 months) with intermittent clarithromycin-including regimens for lung disease due to Mycobacterium Avium Complex. Clin Infect Dis. 2000;30(2):288–92.

    Article  CAS  PubMed  Google Scholar 

  41. van Ingen J, Egelund EF, Levin A, et al. The pharmacokinetics and pharmacodynamics of pulmonary Mycobacterium Avium Complex disease treatment. Am J Respir Crit Care Med. 2012;186(6):559–65.

    Article  PubMed  Google Scholar 

  42. Miwa S, Shirai M, Toyoshima M, et al. Efficacy of clarithromycin and ethambutol for Mycobacterium Avium Complex pulmonary disease. A preliminary study. Ann Am Thorac Soc. 2014;11(1):23–9.

    Article  PubMed  Google Scholar 

  43. Nelson KG, Griffith DE, Brown BA, et al. Results of operation in Mycobacterium Avium-intracellulare lung disease. Ann Thorac Surg. 1998;66(2):325–30.

    Article  CAS  PubMed  Google Scholar 

  44. Shiraishi Y, Nakajima Y, Takasuna K, et al. Surgery for Mycobacterium Avium Complex lung disease in the clarithromycin era. Eur J Cardiothorac Surg. 2002;21(2):314–8.

    Article  PubMed  Google Scholar 

  45. HB X, Jiang RH, Li L. Treatment outcomes for Mycobacterium Avium Complex: a systematic review and meta-analysis. Eur J Clin Microbiol Infect Dis. 2014;33(3):347–58.

    Article  Google Scholar 

  46. van Ingen J, Ferro BE, Hoefsloot W, et al. Drug treatment of pulmonary nontuberculous mycobacterial disease in HIV-negative patients: the evidence. Expert Rev Anti-Infect Ther. 2013;11(10):1065–77.

    Article  PubMed  Google Scholar 

  47. Kikuchi T, Kobashi Y, Hirano T, et al. Mycobacterium Avium genotype is associated with the therapeutic response to lung infection. Clin Microbiol Infect. 2014;20(3):256–62.

    Article  CAS  PubMed  Google Scholar 

  48. Yamakawa H, Takayanagi N, Miyahara Y, et al. Prognostic factors and radiographic outcomes of nontuberculous mycobacterial lung disease in rheumatoid arthritis. J Rheumatol. 2013;40(8):1307–15.

    Article  PubMed  Google Scholar 

  49. Mori S, Tokuda H, Sakai F, et al. Radiological features and therapeutic responses of pulmonary nontuberculous mycobacterial disease in rheumatoid arthritis patients receiving biological agents: a retrospective multicenter study in Japan. Mod Rheumatol. 2012;22(5):727–37.

    Article  CAS  PubMed  Google Scholar 

  50. Tokuda H, Harigai M, Kameda H, et al. Consensus statements for medical practice: biological agents and lung disease [Abridged English translation by the Japanese Respiratory Society]. Respir Investig. 2017;55(3):229–51.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Respiratory Medicine and Infectious Diseases, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan

    Hiroshi Moro M.D., Ph.D. & Toshiaki Kikuchi M.D., Ph.D.

Authors
  1. Hiroshi Moro M.D., Ph.D.
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  2. Toshiaki Kikuchi M.D., Ph.D.
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Corresponding author

Correspondence to Toshiaki Kikuchi M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Department of Allergy and Rheumatology, Nippon Medical School Graduate School of Medicine, Tokyo, Japan

    Takahisa Gono

  2. Department of Respiratory Medicine, JCHO Tokyo Yamate Medical Center, Tokyo, Japan

    Hitoshi Tokuda

  3. Department of Diagnostic Radiology, Saitama International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan

    Fumikazu Sakai

  4. Department of Pathology , Japanese Red Cross Medical Center, Tokyo, Japan

    Tamiko Takemura

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Moro, H., Kikuchi, T. (2018). Mycobacterium Infections in Rheumatoid Arthritis (Tuberculosis and Nontuberculous Mycobacteriosis). In: Gono, T., Tokuda, H., Sakai, F., Takemura, T. (eds) Lung Disease Associated with Rheumatoid Arthritis. Springer, Singapore. https://doi.org/10.1007/978-981-10-6750-1_11

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  • DOI: https://doi.org/10.1007/978-981-10-6750-1_11

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-6749-5

  • Online ISBN: 978-981-10-6750-1

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