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Published on: March 14, 2017
Tuberculosis in children with sickle cell anaemia: a retrospective study in French tertiary care centres
Nina Droz1,2, Agathe De Lauzanne3, Laurent Holvoet4,5
1Robert Debré Hospital, F-75019, Paris, France. Droznina@gmail.com.
Insights
Tuberculosis (TB) in children with sickle cell anaemia (SCA) presents similarly to the general population. These children typically experience favourable outcomes with standard TB treatment, suggesting SCA may not be a severe risk factor.
Area of Science:
- Pediatrics
- Infectious Diseases
- Hematology
Background:
- Tuberculosis (TB) is a global health issue, disproportionately affecting populations with Sickle Cell Anaemia (SCA), a common genetic disorder.
- Limited data exist on the clinical presentation and outcomes of TB specifically in pediatric SCA patients.
Purpose of the Study:
- To describe the clinical features and treatment outcomes of TB in children diagnosed with SCA.
- To compare TB characteristics and outcomes in children with SCA to a control group without SCA.
Main Methods:
- A retrospective, descriptive study was conducted.
- Data were collected from 11 pediatric patients with SCA diagnosed with TB across three Sickle Cell Disease referral centers in Paris, France.
- Patient data were compared to an age- and sex-matched control group of non-SCA patients with TB.
Main Results:
- The median age of TB diagnosis in children with SCA was 11 years.
- Pulmonary TB was observed in six patients, and extrapulmonary TB in five.
- Mycobacterium tuberculosis was isolated in four cases. All patients achieved recovery after a median of 6 months of anti-TB treatment.
- TB localization and outcomes in SCA patients were similar to the control group.
Conclusions:
- Sickle Cell Anaemia does not appear to be a significant risk factor for severe TB in children, despite the study's small sample size.
- The clinical features and outcomes of TB in children with SCA are comparable to the general pediatric population.
- Further investigation into potential impacts of SCA on anti-TB drug metabolism and dosage monitoring is warranted.
Abstract:
Tuberculosis (TB) and sickle cell anaemia (SCA) may affect the same population of patients, particularly in Africa but also in high-TB incidence areas in developed countries. However, few data are available from children with SCA who develop TB. The aim of this study was to describe the clinical features and outcome of TB diagnosed in children with SCA. We conducted a retrospective, descriptive study in three referral centre of Sickle Cell Disease in Paris, France. We included 11 patients with SCA who develop TB. The median age at TB diagnosis was 11 years [7.5-14.5]. Two patients were asymptomatic and nine patients were symptomatic. Six patients had pulmonary TB (pulmonary, pleural and mediastinal lesions). Five patients had extrapulmonary TB (osteoarticular TB, hepatic TB, cervical and mediastinal TB). Mycobacterium tuberculosis was isolated in four of the 11 cases. All patients recovered after a median of 6 months of anti-TB treatment. The localisation of TB and outcome after treatment in our SCA patients were similar to the one observed in an age-and sex-matched control group of non-SCA patient with TB.
Conclusion:
despite the low number of patients included in our study, SCA does not seem to be a risk factor for severe TB. What is Known: • Tuberculosis (TB) remains a global health problem particularly in developing countries, and Sickle cell anaemia (SCA) is currently one of the most common genetic diseases in the world that mainly affects African populations. • Very few data are available on TB in SCA patients. What is New: • The features of TB in children with SCA seem to be comparable to those expected in general population, with favourable outcomes in response to standard treatment. • Monitoring the dosage of anti-TB treatments could be of interest because of the possible impact of SCA on drug metabolism.
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