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AB0936 Tuberculosis Infection in Mexican Patients with Idiopathic Inflammatory Myopathies: Report of three Cases and Review of the Literature
  1. P.J. Pérez Cruz1,
  2. E. Gόmez-Bañuelos2,
  3. J.E. Aguilar-Arreola1,
  4. A. Saldaña Millán3,
  5. L. Andrade-Ortega4,
  6. L.J. Jara-Quezada5,
  7. M.A. Saavedra5,
  8. O. Vera-Lastra5,
  9. G. Medrano-Ramírez6,
  10. O. Pizano-Martínez2,
  11. B.T. Martín-Márquez2,
  12. R.E. Navarro-Hernandez2,
  13. J. Floresvillar-Mosqueda2,
  14. M. Vazquez-Del Mercado1,2
  1. 1Rheumatology, Hospital Civil de Guadalajara “Dr. Juan I. Menchaca”
  2. 2Instituto de Investigaciόn en Reumatología y del Sistema Músculo Esquelético, Guadalajara, Mexico
  3. 3Rheumatology, Instituto de Investigaciόn en Reumatología y del Sistema Músculo Esquelético, Guadalajara
  4. 4Centro Médico Nacional 20 de Noviembre, ISSSTE
  5. 5Centro Médico Nacional “La Raza”, IMSS
  6. 6Hospital General de México, Ciudad de México, Mexico

Abstract

Background Tuberculosis (TB) is a public health problem, a disease originated by M. tuberculosis (MTB) and other members of Mycobacterium tuberculosis complex. There is scarce information about the MTB infection in polymyositis/dermatomyositis (PM/DM) patients.

Objectives To describe the prevalence and clinical presentation of TB infection in patients diagnosed as PM/DM from the two main cities of Mexico: Guadalajara and Mexico City.

Methods A group of 196 patients with IIM recruited from 2009 to 2014 from four public hospitals were included. We described the clinical characteristics and the possible risk factors for the development of TB infection.

Results We identified three cases of extrapulmonary MTB infection mainly TB tenosynovitis (2) and meningeal TB (1) from a cohort of 196 patients with idiopathic inflammatory myopathies (IIM) recruited in a period of 5 years (2009 to 2014). The three cases presented the TB infection around 12 weeks of immunosuppressive therapy.

Conclusions Diagnosis of extrapulmonary TB should be considered in the clinical approach of IIM patients especially in Mexico and countries with high prevalence of TB infection.

Previous to immunosuppressive therapy in IIM, we suggest to do screening for MTB using Tuberculin Skin Test and chest X-ray. In cases of high clinical suspicion of TB infection, we might use Quantiferon™ (Cellestis Limited, Melbourne, Australia) and Xpert MTB-RIF™ (Cepheid, Sunnyvale, California, US).

Disclosure of Interest None declared

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