在接受抗TNF-α治疗的患者中潜伏结核病的发生频率
İpek Coşkunol1, Onur Turan2, Aysegul Baysak3
1Izmir Atatürk Research and Training Hospital, Chest Diseases Department, İzmir-Turkey.
African health sciences
|January 15, 2024
概括
接受瘤亡因子-α (TNF-α) 阻断剂的患者,即使有化疗预防,也显示出结核病的发病率更高. 在这些患者中,对结核病的仔细监测至关重要,特别是那些接受infliximab治疗的患者.
科学领域:
- 免疫学 免疫学 免疫学
- 类风湿病学 类风湿病学
- 传染性疾病 传染性疾病
背景情况:
- 瘤亡因子-α (TNF-α) 阻断剂广泛用于自身免疫性疾病.
- 结核病 (TB) 是与TNF-α抑制剂治疗相关的已知风险.
- 化疗预防通常用于减轻这些患者的结核病风险.
研究的目的:
- 确定接受TNF-α阻断剂治疗的患者肺结核发病的发生率.
- 为了评估结核病化学预防在这个患者群体中的有效性.
主要方法:
- 在3年内对520名接受抗TNF-α治疗的患者进行了回顾性评估.
- 收集的数据包括放射性成像,结核素皮肤测试 (TST),结核病史,BCG疫苗接种,化学预防和特定的抗TNF-α药物.
- 患者的诊断包括结性脊髓炎,类风湿性关节炎,克罗恩病,性结肠炎,牛皮性关节炎和牛皮.
主要成果:
- 在接受抗TNF-α治疗期间,5名患者 (0.96%) 患有活跃结核病 (4例肺结核,1例肺外结核),主要是因弗力西马布.
- 有活跃结核病的患者包括有性结肠炎 (3) 和化脊柱炎 (2) 的患者.
- 结核病发生在治疗的第5个月和第24个月之间,化学预防的持续时间各不相同 (6-9个月).
结论:
- 与一般人群相比,在接受抗TNF-α治疗的患者中,结核病的发生率更高.
- 在结核病流行地区,对于接受抗TNF-α治疗的患者,特别是因弗力西马布的患者,对结核病的警查和检查至关重要.
- 目前的化疗预防策略可能无法在所有接受TNF-α抑制剂的患者中完全预防结核病的发展.
相关概念视频
Pulmonary Tuberculosis V
180
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...
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...
180
Pulmonary Tuberculosis II
239
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...
239
Pulmonary Tuberculosis IV
143
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...
143
Pulmonary Tuberculosis III
332
Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
The first classification is based on the development of the disease, and it includes the following categories:
332
Pulmonary Tuberculosis I
243
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...
243
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
139
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
139


