Abstract:

Objective This paper analyzed the status of tuberculosis infection patients with rheumatic immune diseases and discussed the characteristics of tuberculosis infection patients with rheumatic autoimmune diseases (RAD).Methods Among the 1218 patients who were screened for tuberculosis, a retrospective analysis was performed on 300 cases of tuberculosis (TB) infection in patients diagnosed as the RAD in Shenzhen Third People’s Hospital and Peking University Shenzhen Hospital between January 2011 and December 2015. Among 300 patients, 32 had systemic lupus erythematosus (SLE), 174 had ankylosing spondylitis (AS), and 73 had rheumatoid arthritis (RA). Besides, another 18 patients with sicca syndrome (SS), and 3 patients with dermatomyositis (DM). Tuberculin skin test (TST), X-ray, CT and aetiological methods were implemented to evaluate the status of tuberculosis infection and patients were followed for 24-36 months.Results Among 300 TB infection patients with rheumatic immune diseases,the incidence of latent tuberculosis infection (LTBI) was 86.33% (259/300), and that of inactive tuberculosis (IATB) was 9.0% (27/300). The incidence of active tuberculosis (ATB) was 4.67% (14/300). The incidence of TB infection in patients with RAD was 54.7% (164/300)in males and 45.3% (136/300) in females, which was statistically significant (χ ²=48.368,P<0.01). Among the 1218 patients who were screened for tuberculosis, the prevalence of TB infection (including LTBI+ATB+IATB), among different RAD patients was different which were as followed, among the patients with SLE, the patients with AS, the RA group, the SS group and the DM group was 9.5% (32/335), 37.7% (174/461), 22.7% (73/321), 26.4% (18/68), and 9.1 (3/33), respectively (χ ²=88.766, P<0.01). The prevalence of LTBI in patients with different rheumatic immune diseases was different, among the SLE group, the AS group, the RA group, the SS group and the DM group was 8.0% (27/335), 33.6% (155/461), 18.7% (60/321), 23.5% (16/68), and 3.0 (1/33) respectively (χ ²=84.971, P<0.01). Conclusion LTBI accounted for the main part of the RAD patients with tuberculosis infections,which was more frequent in males than in females. AS patients had the highest infection rate. Clinicians should enhance their understanding.

Key words: Rheumatic diseases, Latent tuberculosis, Comorbidity, Diagnosis, Antibiotic prophylaxis, Outcome assessment(health care)