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  • Open Access

Tuberculosis in Juvenile Idiopathic arthritis under Anti-TNF therapy

  • 1,
  • 1 and
  • 1
Pediatric Rheumatology20119 (Suppl 1) :P72

https://doi.org/10.1186/1546-0096-9-S1-P72

  • Published:

Keywords

  • Arthritis
  • Tuberculosis
  • Prevalent Disease
  • Juvenile Idiopathic Arthritis
  • Mycobacterium Tuberculosis

Tuberculosis (TB) is still a prevalent disease, one third of the population is infected by mycobacterium tuberculosis (MT).Treatment with anti TNF therapies appears to increase the risk for developing TB

Aim

To study the occurrence of latent TB (LTB) or tuberculosis disease (TBD) in children with JIA under anti TNF therapy.

Methods

Clinical records from pts with JIA ( ILAR´01) under anti-TNF therapy were reviewed, focusing on TB screening prior to biologicals , PPD conversion or TBD diagnosiss.LTB was considered as a PPD (TST) positive (≥ 5 mm), in the abscense of radiological manifestations of TB.

Results

105 JIA pts received one or more anti TNF drugs during the observation. Four of them developed LTB and 3 others TBD.

Table

 

Gender/ age( ys)

Dx

PPD (mm)*

TBDisease

antiTNF

Time under 1st Biologic

TB tx

2nd Biological Tx

Pt 1

M / 18

pJIA

18

no

ETN

24 m

INH

No

Pt 2

F/ 20

oJIA

12

no

ADA

24 m

INH

No

Pt 3

F / 7

pJIA

6

no

ETN

11 m

INH

INF

Pt 4

M / 13

sJIA

13

no

IFX

1 m

INH

No

Pt 5

F / 14

pJIA

10

Pulmonar involvement

IFX

6 m

4 drugs

ETN

Pt 6

F / 17

pJIA

13

Pulmonar involvement

IFX

24 m

4 drugs

No

Pt 7

F / 12

pJIA

13

Pulmonar involvement

ETN

30 m

4 drugs

ETN

No extrapulmonar TB or miliary forms were observed. All patients were PPD negative prior to biological agents

Conclusions

No significative difference was found between specific anti TNF and the occurrence of LTB or TBD. In 4 pts, the infectious event occurred after 2 ys of exposure and in two earlier as described in the literature. This data highlights the importance of TB surveillance prior to and during anti-TNF therapy.

Authors’ Affiliations

(1)
Rheumatology and Tisiology Sections, Hospital de Niños, Dr Ricardo Gutierrez, Buenos Aires, Argentina

Copyright

© Espada et al; licensee BioMed Central Ltd. 2011

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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