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The ever-expanding association between rheumatologic diseases and tuberculosis
Carlos Franco-Paredes1, Alejandro Díaz-Borjon, Mark A Senger
1Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Ga, USA. cfranco@sph.emory.edu
The American Journal of Medicine
|June 6, 2006
Summary
Tuberculosis (TB) and Mycobacterium tuberculosis disease can directly impact the musculoskeletal system. This includes direct infections, acting as a pathogen in rheumatologic diseases, drug-induced syndromes, and reactive immune responses.
Area of Science:
- Rheumatology
- Infectious Diseases
- Immunology
Background:
- Tuberculosis (TB) is a significant global health concern.
- Rheumatologic diseases encompass a wide range of autoimmune and inflammatory conditions.
- The interplay between TB and rheumatologic conditions requires comprehensive understanding.
Purpose of the Study:
- To summarize the rheumatologic manifestations of tuberculosis (TB).
- To explore the occurrence of Mycobacterium tuberculosis disease in patients with rheumatologic diseases.
- To categorize the diverse ways TB affects the musculoskeletal system.
Main Methods:
- Literature review and synthesis of existing studies.
- Categorization of TB-related musculoskeletal conditions into four main groups.
- Inclusion of adverse events associated with TB prevention (BCG vaccine) and treatment.
Main Results:
- Direct musculoskeletal involvement: spondylitis, osteomyelitis, septic arthritis, tenosynovitis.
- TB as an infectious pathogen: particularly with immunosuppressive therapies like TNF-alpha inhibitors.
- Drug-induced syndromes: tendinopathy, drug-induced lupus from antimycobacterial drugs.
- Reactive immunologic phenomena: reactive arthritis, erythema nodosum.
- Musculoskeletal adverse events from BCG vaccination.
Conclusions:
- Mycobacterium tuberculosis can directly infect and damage the musculoskeletal system.
- TB can be an opportunistic infection in patients with rheumatologic diseases, especially those on immunomodulatory treatments.
- Antimycobacterial drugs and BCG vaccination can also lead to rheumatologic complications.
- A comprehensive approach is needed to diagnose and manage TB in patients with rheumatologic conditions.
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