Adenitis tuberculosa tras tratamiento con éxito de hepatitis C

Velasco, Javier; González, Silvia Tatiana

doi:10.1016/j.eimc.2011.03.009

Cited by 8 publications

(2 citation statements)

References 10 publications

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“…Es remarcable también el aumento de LT en pacientes autóctonos en tratamiento inmunosupresor. Está bien documentada la mayor susceptibilidad a la TB de los pacientes en tratamiento inmunosupresor, concretamente se describen casos de LT tras iniciar tratamiento biológico 15 , por lo que es indispensable descartar tanto la infección latente como la enfermedad tuberculosa activa antes de iniciarlos 16 .…”

Section: Figura 1 Algoritmo Para El Diagnóstico Precoz De Linfadenitiunclassified

Valoración epidemiológica de la linfadenitis tuberculosa en un distrito de Barcelona: propuesta de algoritmo diagnóstico

Aguilar-Duran

Sánchez‐Martínez

2014

Rev. Esp. Salud Publica

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RESUMENFundamentos: Barcelona ha experimentado un cambio en su demografía que ha afectado la epidemiología local de la linfadenitis tuberculosa (LT). El objetivo del estudio es conocer los factores actualmente asociados a LT en un distrito de Barcelona con una incidencia media de TB superior a 50 casos por 10.000 habitantes/año así como plantear un algoritmo diagnóstico.Métodos: estudio de cohortes retrospectivo de todos los casos de LT diagnosticados entre 1990 y 2009 en el Hospital del Mar de Barcelona. De acuerdo a los cambios demográficos, se establecieron dos periodos de estudio (1990-1999 y 2000-2009) y se analizaron y compararon las características sociodemográficas, clínicas y diagnósticas de los sujetos con LT para la posterior realización del algoritmo. La información se obtuvo de las encuestas epidemiológicas realizadas a los pacientes diagnosticados de LT en el Hospital del Mar y notificadas a la Agència de Salut Pública de Barcelona.Resultados: en el primer periodo, 152 pacientes presentaron LT (siendo 73,7% autóctonos) y en el segundo 147 (siendo 70,7% inmigrantes). En el primer periodo, el porcentaje de hombres immigrantes fue del 70,5% y 57,1% menores de 35 años, aunque en el segundo periodo se observó en autóctonos e l 58,1% de mujeres y 69,8% mayores de 35 años. El porcentaje de pacientes autóctonos con VIH disminuyó de 66,9% a 44,2% en el segundo periodo y hubo aumento de pacientes en tratamiento inmunosupresor (9,3%). El análisis multivariante dio como resultado (OR 8,2;IC 95% 3,4-19,8) para el uso de drogas intravenosas y OR 4,8 (IC95% 2,7-8,3)para la inmigración como factores de riesgo a LT.Conclusiones: los varones inmigrantes menores de 35 años procedentes de zonas endémicas de tuberculosis y los autóctonos mayores de 35 años con VIH (aunque con un menor porcentaje de coinfección que antes del año 2000) o en tratamiento inmunosupresor son los grupos con más riesgo de presentar LT en nuestro distrito. Background: Barcelona (Spain) has experienced a dramatic change in its demography, which is reflected in the local epidemics of tuberculous lymphadenopathy (TL). The objective of the study is to analyze the associated risk factors to TL in a district of Barcelona with an incidence above 50 cases per 10,000 inhabitants/year, which will help to construct a diagnostic algorithm.

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Section: Figura 1 Algoritmo Para El Diagnóstico Precoz De Linfadenitiunclassified

Valoración epidemiológica de la linfadenitis tuberculosa en un distrito de Barcelona: propuesta de algoritmo diagnóstico

Aguilar-Duran

Sánchez‐Martínez

2014

Rev. Esp. Salud Publica

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“…The clinical presentation of the disease includes cellulitis, subcutaneous abscesses, respiratory tract colonization and systemic alterations [5] . In addition, specific reports of humans infections by P. pneumotropica include a wide variety of clinical findings, such as: left-sided and right-sided endocarditis [6] , [7] ; pneumonia in patients with α anti-trypsin deficiency [8] and HIV [9] ; meningitis [10] , osteomyelitis and arthritis associated with dog bites [11] ; septicemia in an elderly woman living with cats [12] ; peritonitis in a patient receiving dialysis [13] ; and epidural abscess [14] .…”

Section: Introductionmentioning

confidence: 99%

Pasteurella pneumotropica Evades the Human Complement System by Acquisition of the Complement Regulators Factor H and C4BP

et al. 2014

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Pasteurella pneumotropica is an opportunist Gram negative bacterium responsible for rodent pasteurellosis that affects upper respiratory, reproductive and digestive tracts of mammals. In animal care facilities the presence of P. pneumotropica causes severe to lethal infection in immunodeficient mice, being also a potential source for human contamination. Indeed, occupational exposure is one of the main causes of human infection by P. pneumotropica. The clinical presentation of the disease includes subcutaneous abscesses, respiratory tract colonization and systemic infections. Given the ability of P. pneumotropica to fully disseminate in the organism, it is quite relevant to study the role of the complement system to control the infection as well as the possible evasion mechanisms involved in bacterial survival. Here, we show for the first time that P. pneumotropica is able to survive the bactericidal activity of the human complement system. We observed that host regulatory complement C4BP and Factor H bind to the surface of P. pneumotropica, controlling the activation pathways regulating the formation and maintenance of C3-convertases. These results show that P. pneumotropica has evolved mechanisms to evade the human complement system that may increase the efficiency by which this pathogen is able to gain access to and colonize inner tissues where it may cause severe infections.

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High incidence of tuberculosis in patients treated for hepatitis C chronic infection

Uehara

Emori

Perez

et al. 2016

The Brazilian Journal of Infectious Diseases

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Brazil is one of the 22 countries that concentrates 80% of global tuberculosis cases concomitantly to a large number of hepatitis C carriers and some epidemiological risk scenarios are coincident for both diseases. We analyzed tuberculosis cases that occurred during α-interferon-based therapy for hepatitis C in reference centers in Brazil between 2001 and 2012 and reviewed their medical records. Eighteen tuberculosis cases were observed in patients submitted to hepatitis C α-interferon-based therapy. All patients were human immunodeficiency virus-negative. Nine patients (50%) had extra-pulmonary tuberculosis; 15 (83%) showed significant liver fibrosis. Hepatitis C treatment was discontinued in 12 patients (67%) due to tuberculosis reactivation and six (33%) had sustained virological response. The majority of patients had a favorable outcome but one died. Considering the evidences of α-IFN interference over the containment of Mycobacterium tuberculosis, the immune impairment of cirrhotic patients, the increase of tuberculosis case reports during hepatitis C treatment with atypical and severe presentations and the negative impact on sustained virological response, we think these are strong arguments for latent tuberculosis infection screening before starting α-interferon-based therapy for any indication and even to consider IFN-free regimens against hepatitis C when a patient tests positive for latent tuberculosis infection.

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Adenitis tuberculosa tras tratamiento con éxito de hepatitis C

Cited by 8 publications

References 10 publications

Valoración epidemiológica de la linfadenitis tuberculosa en un distrito de Barcelona: propuesta de algoritmo diagnóstico

Valoración epidemiológica de la linfadenitis tuberculosa en un distrito de Barcelona: propuesta de algoritmo diagnóstico

Pasteurella pneumotropica Evades the Human Complement System by Acquisition of the Complement Regulators Factor H and C4BP

High incidence of tuberculosis in patients treated for hepatitis C chronic infection

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