Mycobacterium tuberculosis infection in a corticosteroid-treated rheumatic disease patient population.
Objective To investigate the incidence and risk factors of Mycobacterium tuberculosis infection in longterm corticosteroid treated rheumatic disease patients.
Methods We assessed retrospectively the incidence of active tuberculosis and its risk factors in 269 rheumatic disease patients treated with moderate to high doses of corticosteroid for an evaluation period representing 1,035 corticosteroid years of therapy.
Results The mean daily dose of steroid was 18.7 mg prednisolone and the mean daily dose during the first year of treatment was 20.4 mg prednisolone. 21 of these patients developed active tuberculosis resulting in an incidence rate of 20/1,000 patient-years.
Cumulative and mean daily steroid doses during the follow-up period and during the first year of treatment, and a history of steroid pulse therapy were significantly correlated with the development of tuberculosis.
A past history of tuberculosis, initial chest P-A abnormality, the starting dose of steroid, a history of more than 30 mg/day of prednisolone for more than one month, and a history of cytotoxic therapy were not related to the development of tuberculosis.
Conclusion The incidence of active tuberculosis is increased in rheumatic patients on moderate-to-high dose steroid treatment.
Its risk factors are the cumulative and mean daily steroid doses during the follow-up period and during the first year of steroid treatment, and a history of steroid pulse therapy.
Mots-clés Pascal : Tuberculose, Mycobactériose, Bactériose, Infection, Mycobacterium tuberculosis, Mycobacteriaceae, Mycobacteriales, Actinomycetes, Bactérie, Epidémiologie, Incidence, Facteur risque, Polyarthrite rhumatoïde, Association, Traitement, Corticostéroïde, Chimiothérapie, Long terme, Homme, Chronique, Système ostéoarticulaire pathologie, Rhumatisme inflammatoire, Immunopathologie, Maladie autoimmune
Mots-clés Pascal anglais : Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Mycobacterium tuberculosis, Mycobacteriaceae, Mycobacteriales, Actinomycetes, Bacteria, Epidemiology, Incidence, Risk factor, Rheumatoid arthritis, Association, Treatment, Corticosteroid, Chemotherapy, Long term, Human, Chronic, Diseases of the osteoarticular system, Inflammatory joint disease, Immunopathology, Autoimmune disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0217215
Code Inist : 002B05B02O. Création : 11/09/1998.