Pathomorphosis of Extrapulmonary Tuberculosis in Children

Abstract

Aim. To study clinical and epidemiological aspects of pathomorphosis of extrapulmonary tuberculosis clinical forms. Materials and Methods. Retrospective analysis of 138 case histories in children aged to 15 years, obtaining extrapulmonary tuberculosis treatment in a specialized children's hospital during 1988-2015 was carried out. Among them, in 103 children, clinical forms of extrapulmonary tuberculosis combined with respiratory tuberculosis and in 35 children independent forms of extrapulmonary tuberculosis were found. Studied stage (1988-2015) was divided into 3 periods: I – 1988-1997, II – 1998-2007, III – 2008-2015. During 2008-2015, incomparison to previous periods, the number of cases of peripheral lymph node tuberculosis (PLN), meninges and central nervous system tuberculosis, bones and joints tuberculosis, and ocular tuberculosis decreased. In 2008-2015, the share of combined forms of meninges and central nervous system tuberculosis and ocular tuberculosis remained at 1998-2007 level. During 2008-2015, skin tuberculosis was not diagnosed. Nevertheless, in 2008-2015, in6.8±10.2 % of cases extrapulmonary tuberculosis combined with miliary tuberculosis, and in 5.8±10.4 % of cases the process characterized by lethal outcome, moreover 4.9±10.7% from them – in recent years. It is important that during period I, in 19.6±13.2 % of cases extrapulmonary tuberculosis combined with respiratory tuberculosis in reverse development phases, during period II – in 12.9±19.3 % of cases, during period III – in 23.8±21.2 % of cases. Conclusion. Despite the reduction, extrapulmonary tuberculosis combined with severe forms of respiratory tuberculosis, which led to lethal outcome in children in 5.8±10.4% of cases. Tuberculosis epidemiological situation worsening, reversion of severe forms of tuberculosis with the development of extrapulmonary one and several organs injuries in children shows the necessity of social, preventive and therapeutic measures intensification among children.

The efficiency of immune modulator BIVEL for the prevention of pulmonary tuberculosis in exposed children from the multidrug-resistant tuberculosis sites

“…Mykolyshyn and Z.I. Piskur [10] state that vitamin D deficiency was evident in 43.8% of the children diagnosed with respiratory tuberculosis. 37.5% children suffered from the vitamin deficiency, and the vitamin level was within the norm only in 18.8% cases.…”

Changes of the pro-hormone levels of vitamin D 25(OH)D in patients with newly diagnosed pulmonary tuberculosis treatment failure

“…In contrast to foreign authors, the role of vitamin D in the course of tuberculosis in children [12] and in adults with comorbid tuberculosis/chronic obstructive pulmonary disease [13] has been studied by Ukrainian scientists.…”