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TB and coeliac disease.

Anjali Shetty1, Mike Mckendrick

  • 1Infectious Diseases Unit, Royal Hallamshire Hospital, Sheffield, UK. anjalishettyuk@yahoo.co.uk

The Journal of Infection
|December 12, 2003
PubMed
Summary

Two patients with pulmonary tuberculosis resistant to treatment were diagnosed with coeliac disease. Managing coeliac disease with a gluten-free diet improved tuberculosis medication absorption and treatment response.

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Pulmonary tuberculosis (TB) is a significant global health challenge, often requiring prolonged antibiotic therapy.
  • Treatment failure in TB can arise from various factors, including medication adherence, drug resistance, and underlying comorbidities.
  • Malabsorption syndromes can potentially impact the efficacy of oral medications used in TB treatment.

Observation:

  • Two cases of pulmonary tuberculosis demonstrated a lack of response to standard, adequate therapeutic regimens.
  • Diagnostic investigations revealed concurrent coeliac disease in both patients.
  • Coeliac disease was identified as the underlying cause of malabsorption, hindering the effective uptake of oral anti-TB drugs.

Findings:

  • Successful treatment of coeliac disease, through implementation of a strict gluten-free diet, resolved the malabsorption issue.
  • Following the dietary intervention for coeliac disease, patients achieved a positive clinical response to their pulmonary tuberculosis therapy.
  • This suggests a direct link between undiagnosed coeliac disease and TB treatment failure due to medication malabsorption.

Implications:

  • Highlights the importance of considering gastrointestinal comorbidities like coeliac disease in patients with refractory tuberculosis.
  • Undiagnosed coeliac disease can lead to treatment failure of infectious diseases by impairing oral drug bioavailability.
  • Screening for malabsorption disorders may be beneficial in patients with persistent or unresponsive infections, particularly those on oral medications.

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