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Increased risk of pulmonary and extra-pulmonary tuberculosis in patients with rheumatic diseases
OBJECTIVE: To investigate the risk of PTB and EPTB in patients with rheumatic diseases using a population-based database.
DESIGN: From Taiwan's National Health Insurance Research Database, 8536 patients with tuberculosis (TB) were frequency-matched with 42 680 controls for sex, 10-year age group and index year. Subjects were retrospectively traced back for their first diagnosis of rheumatic diseases. The association between TB and rheumatic diseases was assessed using multivariate logistic regression analyses.
RESULTS: The risk of developing PTB was significantly higher in patients with systemic lupus erythematosus (adjusted odds ratio [aOR] 4.90, P < 0.001), rheumatoid arthritis (RA) (aOR 2.00, P < 0.001) and Sjögren's syndrome (aOR 6.11, P < 0.001). In addition, the risks of developing EPTB were significantly higher in RA patients (aOR 4.67, P < 0.001), those with Sjögren's syndrome (aOR 5.94, P < 0.001), and the group comprising progressive systemic sclerosis, polymyositis or dermatomyositis (aOR 8.31, P = 0.021).
CONCLUSION: Elevated risks of PTB and EPTB were associated with various rheumatic diseases. Rheumatologists should be vigilant to the possibility of TB, and particularly EPTB, in their patients.
Keywords: Sjögren's syndrome; case-control study; rheumatoid arthritis; systemic autoimmune diseases; systemic lupus erythematosus
Document Type: Research Article
Affiliations: 1: Division of Allergy, Immunology and Rheumatology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan 2: School of Medicine, Tzu Chi University, Hualien, Taiwan; Division of Pulmonology and Critical Care, Dalin Tzu Chi Hospital, Taiwan 3: School of Medicine, Tzu Chi University, Hualien, Taiwan; Division of Infectious Diseases, Dalin Tzu Chi Hospital, Taiwan 4: Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
Publication date: 01 December 2015
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