Extrapulmonary Tuberculosis (EPTB)

Author: Jo Frowde. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Extrapulmomary Tuberculosis
Autoimmunity and Mycobacterium
Scleroderma and Tuberculosis


Tuberculosis KaleidoscopeTuberculosis is not an autoimmune disease, however when it spreads outside the lungs, it can affect any part of the body and thus it can imitate many autoimmune diseases, especially other systemic diseases such as scleroderma and lupus. (Also see What is Scleroderma? and Systemic Lupus Erythematosus)

What is Tuberculosis? Tuberculosis is a bacterial disease usually affecting the lungs (pulmonary TB). Other parts of the body can also be affected, for example lymph nodes, kidneys, bones, joints, etc. (extrapulmonary TB). New York State Department of Health.


Tuberculosis is caused by mycobacterium tuberculosis. Over one third of the world's population has latent or active mycobacterial infection.

Pulmonary tuberculosis is contagious and is usually spread by coughs and sneezes after prolonged close contact. So, it is much more likely to catch it from a family member or co-worker who has not yet had sufficient antibiotics, than from exposure in stores or public transportation.

Extrapulmonary Tuberculosis (EPTB)

Tuberculosis is most well known for affecting the lungs. However in about 20% of cases it occurs outside of the lungs, and then it is called extrapulmonary, miliary, or disseminated tuberculosis.

TB or Not TB: The Weirdness that is Extra-Pulmonary Tuberculosis. EPTB can manifest itself in nearly every type of organ system of the body, though the most common sites are the lymph nodes, urinary tract and reproductive system, meninges of the brain, bones and joints, pleural cavity, skin, and peritoneal cavity. Discover Blog, 2012.

Autoimmunity and Mycobacterium

The effect of anti-tuberculosis treatment on levels of anti-phospholipid and anti-neutrophil cytoplasmatic antibodies in patients with active tuberculosis. Anti-TB treatment may induce normalization of anti-lactoferrin and anti-myeloperoxidase (MPO), and de novo anti-proteinase 3 and MPO formation. PubMed, Rheumatol Int, 2013 Apr;33(4):949-53.

Associations between selected immune-mediated diseases and tuberculosis (TB): record-linkage studies. These two databases show that patients with some immune-mediated diseases have an increased risk of TB, although we cannot explicitly state the direction of risk or exclude confounding. BMC Medicine 2013, 11:97.

Mycobacterium tuberculosis triggers autoimmunity? It is important to screen all tuberculosis patients for autoantibody profile and should be followed up after the treatment for any flaring up of autoimmune related symptoms. PubMed, Indian J Tuberc, 2012 Jan;59(1):49-51.

Potential T cell epitopes of Mycobacterium tuberculosis that can instigate molecular mimicry against host: implications in autoimmune pathogenesis. Some of the epitopes were promiscuously binding to predominantly occurring HLA alleles and corroborated well with established autoimmune diseases. BMC Immunology 2012, 13:13.

Scleroderma and Tuberculosis

Systemic Sclerosis (SSc) and the Risk of Tuberculosis (TB). In this nationwide study, the incidence of TB infection was significantly higher among patients with SSc than in controls without SSc and special care should be taken in managing patients with SSc who are at high risk for TB. PubMed, J Rheumatol, 2014 Jul 15.


How good are systemic symptoms and blood inflammatory markers at detecting individuals with tuberculosis? In our population, TB, including pulmonary disease, frequently presented without fever, sweats or weight loss and with normal blood inflammatory markers. PubMed, Int J Tuberc Lung Dis, 2008 Jan;12(1):44-9.


Extrapulmonary Tuberculosis Symptoms. Mycobacteria can infect virtually any part of the body and onset slowly, imitating many other diseases. General symptoms include fatigue, malaise, fever, weight loss, anorexia, fever. It can affect the kidneys, bladder, muscles, joints, bones, heart, central nervous system, lymph nodes, and gastrointestinal tract.


WHO recommends new test, treatment plan for superbug strains of TB. The World Health Organization recommended a speedier, cheaper treatment plan for patients with superbug forms of tuberculosis (TB) — a change that should help cure thousands of the killer disease. Reuters Health, 05/12/2016.

Therapy duration and long-term outcomes in extra-pulmonary tuberculosis. There is a combination therapy duration point associated with the best long-term outcome, and therapy duration beyond this point leads to poorer survival. Thus, unnecessarily long therapy could be harmful to patients. BMC Infec Dis, 2014; 14:115.

Drug-Resistant TB a 'Ticking Bomb,' Warns WHO. The World Health Organization (WHO) warns of a "ticking time bomb" as tuberculosis is getting increasingly resistant to antibiotics. Times Healthland, 12/12/2013.

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