Related Experiment Videos
Risk for active tuberculosis in inflammatory bowel disease patients
Faten N Aberra1, Nicolas Stettler, Colleen Brensinger
1Division of Gastroenterology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Summary
Patients with inflammatory bowel disease (IBD) had a higher risk of active tuberculosis (TB) before infliximab treatment. Immunosuppressants were likely the cause of this increased TB risk in IBD patients.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Epidemiology
Background:
- Inflammatory bowel disease (IBD) encompasses chronic conditions like ulcerative colitis and Crohn's disease.
- The pre-infliximab era (before 1990s) lacked advanced biologic therapies for IBD.
- Understanding baseline tuberculosis (TB) risk in IBD patients is crucial for risk stratification.
Purpose of the Study:
- To determine the incidence of active TB in IBD patients.
- To compare TB incidence in IBD patients versus the general population.
- To assess TB risk factors in IBD patients before infliximab.
Main Methods:
- Retrospective cohort study using the General Practice Research Database (1988-1997).
- Matched IBD patients (ulcerative colitis, Crohn's disease) with controls (1:4 ratio).
- Analysis of TB diagnostic codes and multivariate logistic regression for confounders (corticosteroids, smoking).
Main Results:
- 16,213 IBD patients and 66,512 controls were analyzed.
- Annual active TB incidence was 20/100,000 in IBD vs. 9/100,000 in controls (unadjusted RR 2.36).
- Adjusted odds ratio for TB in IBD was 1.88, though not statistically significant (95% CI, 0.68-5.20).
Conclusions:
- IBD patients faced a higher risk of active TB in the pre-infliximab era.
- Immunosuppressant medication use is a likely contributor to increased TB risk.
- This highlights the importance of TB screening in IBD patients, especially those on immunosuppressants.
Related Concept Videos
01:28Pulmonary Tuberculosis II
Tuberculosis, or TB, is a bacterial infectious disease caused by Mycobacterium tuberculosis. While its primary impact is on the lungs, leading to pulmonary tuberculosis, it can also affect various other organs, a condition referred to as extrapulmonary tuberculosis.
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
Here is a detailed explanation of its pathophysiology:
Transmission: The process begins when a person inhales droplet nuclei containing M. tuberculosis. These are typically released into the air when an individual with pulmonary or...
01:29Pulmonary Tuberculosis I
Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
01:25Inflammatory Bowel Disease III: Crohn's Disease
Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...
01:28Pulmonary Tuberculosis V
Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the progression...
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the progression...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:26Pulmonary Tuberculosis IV
Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...