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Published on: December 17, 2021
Neuromyelitis optica and pulmonary tuberculosis: a case-control study.
1Division of Neurology, Tygerberg Hospital, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa.
Summary
Neuromyelitis optica (NMO) is linked to pulmonary tuberculosis (TB). Patients with NMO were more likely to have active TB, suggesting an immune-mediated response to Mycobacterium tuberculosis infection.
Area of Science:
- Neuroimmunology
- Infectious Diseases
- Demyelinating Diseases
Background:
- Neuromyelitis optica (NMO), or Devic's disease, is a rare inflammatory condition causing demyelination in the spinal cord and optic nerves.
- While often isolated, NMO has been anecdotally linked to active pulmonary tuberculosis (TB).
Purpose of the Study:
- To investigate a potential association between Neuromyelitis optica (NMO) and pulmonary tuberculosis (TB).
Main Methods:
- A retrospective case-control study design was employed.
- Adult patients diagnosed with NMO between 1995 and 2011 were included.
- Controls comprised patients diagnosed with Guillain-Barré syndrome.
Main Results:
- Eleven of fourteen NMO patients (79%) had a preceding or simultaneous diagnosis of pulmonary TB (PTB), with TB diagnosed a median of 4 weeks prior to NMO onset.
- Only two control patients had PTB.
- The odds ratio for active PTB in the NMO group versus controls was 4.6 (95% CI 1.71-15.49).
Conclusions:
- A significant association exists between Neuromyelitis optica (NMO) and pulmonary tuberculosis (TB) in this population.
- The findings suggest an immune-mediated mechanism where Mycobacterium tuberculosis infection triggers inflammatory demyelination in NMO.
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