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FRI0098 The incidence and clinical characteristics of mycobacterium tuberculosis infection among sle and ra patients in korea
  1. T Kim,
  2. J Yun,
  3. D Yoo,
  4. J Jun,
  5. S Jung,
  6. I Lee,
  7. S Bae,
  8. S Kim
  1. Rheumatology, The Hospital for Rheumatic Diseases, Seoul, Korea

Abstract

Background A prevalence rate in a general population estimated by chest x-ray was reported 1.03% in 1995.

Objectives The aim of this study was to describe the incidence and clinical characteristics of M. tuberculosis infection among SLE and RA patients in Korea.

Methods We assessed retrospectively 283 SLE and 284 RA patients with median disease duration of 6 years and 9 years, respectively.

Results Tuberculosis was documented from 15 SLE and 7 RA patients with the incidence rate of 7.9/1,000 patient-years and 2.3/1,000 patient-years, respectively (p < 0.05). SLE-associated tuberculosis included 3 miliary tuberculosis, 7 pulmonary tuberculosis (including 1 diffuse pulmonary involvement with meningitis) predominantly involved in mid-/lower lung field more than 2 lobes, and 5 extra-pulmonary forms (2 osteomyelitis, renal tuberculosis, laryngeal tuberculosis, pleurisy). Four out of seven pulmonary tuberculosis were relapsed cases even after adequately treated. All RA-associated tuberculosis were a pulmonary tuberculosis and most of them were localised to one lobe, and also only 1 case was relapsed. All patients were successfully treated except for two died of miliary tuberculosis. A history of high dose steroid or cytotoxic drugs and any organ involvement were not related to the development of tuberculosis. SLE-associated tuberculosis was developed 48.13 ¢®¨ú35.14 months after their initial symptom and 20.87 ¢®¨ú23.53 months after clinical diagnosis.

Conclusion Taken together characteristics of tuberculosis in SLE patients are; 1) a higher incidence rate, 2) more frequent extra-pulmonary involvements, 3) more extensive pulmonary involvements 4) a higher relapse rate (Odds ratio 4.14). Thus, the contributory role of M. tuberculosis infection in the morbidity and mortality of patients with SLE must be emphasised, especially in areas endemic for M. tuberculosis.

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  4. Kim HA, Yoo CD, Baek HJ, et al. Mycobacterium tuberculosis infection in a corticosteroid-treated rheumatic disease paient population. Clin Exp Rheumatol. 1998;16:9–13

  5. Kim SJ, Hong YP, Lew WJ, Yang SC, Lee EG. Incidence of pulmonary tuberculosis in Korean civil servants. Tuber Lung Dis. 1995;76:534–9

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