Clinical Features and Risk Factors of Active Tuberculosis in Patients with Behçet’s Disease

Abstract

To investigate the clinical features and potential risk factors of active tuberculosis (ATB) in Behçet’s disease (BD), we conducted a case-control study on hospitalized BD patients in our institute from 2010 to 2019. BD patients with ATB were enrolled as the case group. The control group was selected by random number sampling from the remaining BD patients, including those with latent tuberculosis infection, previous tuberculosis, or without tuberculosis. Finally, we reviewed 386 BD patients and identified 21 (5.4%) ATB cases, including four (19.0%) microbiologically confirmed and 17 (81.0%) clinically diagnosed. We found that BD patients with ATB were more prone to have systemic symptoms (fever, night sweating, and unexplained weight loss) and/or symptoms related to the infection site. Multivariate logistic regression analysis revealed that erythrocyte sedimentation rate ESR > 60 mm/h ( OR = 13.710 , 95% CI (1.101, 170.702)), increased IgG ( OR = 1.226 , 95% CI (1.001, 1.502)), and positive T-SPOT.TB ( OR = 7.793 , 95% CI (1.312, 48.464), for 24-200 SFC/106PBMC; OR = 17.705 95% CI (2.503, 125.260), for >200 SFC/106PBMC) were potential risk factors for ATB in BD patients. Our study suggested that when BD patients have systemic symptoms with significantly elevated TB-SPOT, the diagnosis of ATB should be considered.

Prevalence and risk factors of active tuberculosis in patients with rheumatic diseases: a multi-center, cross-sectional study in China

“…Few studies reported the prevalence of ATB in patients with BD. Our previous study showed that 5.4% of the hospitalized patients with BD were diagnosed with ATB[ 24 ]. Similarly, the prevalence of ATB in hospitalized patients with BD was higher than that obtained in this epidemiological survey (2251/100,000).…”

Persistent infection of Mycobacterium tuberculosis in a patient with Behçet’s disease after rotator cuff repair surgery: A case report

“…It is frequently observed in patients along the Silk Road in Asia and Central Asia. [ 8 ] Mycobacterium tuberculosis is known to trigger Behçet's disease. [ 9 ] Moreover, the incidence of TB infection in Behçet's disease sufferers increases significantly, due to both cell-mediated immune system disorders observed in these patients, and the medications used in the treatment of this disease that suppress the immune system, in particular, anti- TNF agents.…”

“…[ 9 ] Moreover, the incidence of TB infection in Behçet's disease sufferers increases significantly, due to both cell-mediated immune system disorders observed in these patients, and the medications used in the treatment of this disease that suppress the immune system, in particular, anti- TNF agents. [ 8 ] Consequently, TB infection in Behçet's disease sufferers can be both the cause and the result. In the present case, however, the patient was not using anti-TNF agents and TB infection developed.…”

Neuro-Behçet’s Disease Onset in the Context of Tuberculous Meningoencephalitis: A Case Report

“…Moreover, in a recent study by Shen et al, BD patients with latent Mycobacterium infection were shown to have worse clinical outcomes, with more severe dermatological and ophthalmological damage [20]. Moreover, BD patients with active TB seem more prone to having systemic symptoms, including fever and weight loss, arthritis, and thrombotic events [23].…”