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Extrapulmonary Tuberculosis (EPTB)

Author: Jo Frowde. Scleroderma is highly variable. See Types of Scleroderma. Read Disclaimer
Overview
Causes
Extrapulmomary Tuberculosis
Autoimmunity and Mycobacterium
Scleroderma and Tuberculosis
Diagnosis
Symptoms
Treatments

Overview

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.

Causes

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.

Mannose–binding lectin (MBL) deficiency and tuberculosis infection in patients with ankylosing spondylitis (AS). We found a significant association between MBL deficiency and higher risk of tuberculosis and urinary tract infection in patients with AS. PubMed, Clin Rheumatol, 09/06/2017. (Also see Ankylosing Spondylitis)

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.

Case Report: Extra pulmonary tuberculosis presenting as fever with massive splenomegaly and pancytopenia. We report the case of a 13-year old male who presented with fever, weight loss, pallor and massive splenomegaly with pancytopenia. PubMed, IDCases, 2016 Mar 2;4:20-2. (Also see Liver and Spleen Involvement)

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.

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.

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.

Diagnosis

The Transcriptional Signature of Active Tuberculosis Reflects Symptom Status in Extra–Pulmonary and Pulmonary Tuberculosis (TB). The transcriptional signature in extra–pulmonary TB demonstrated heterogeneity of gene expression reflective of symptom status, while the signature of pulmonary TB was distinct, based on a higher proportion of symptomatic individuals. PubMed, PLoS One, 2016 Oct 5;11(10):e0162220.

Symptoms

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. Patient.info.

Treatments

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.

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