Mycobacterium tuberculosis infection precipitates SLE in patients from endemic areas.
In a cohort of 70 systemic lupus erythematosus (SLE) patients diagnosed over 2 years period, 14 patients were found to have confirmed antecedent tuberculosis (20.0%) which was 40 times higher (p < 0.001, 95%CI 36.2-48.6) than the prevalence of tuberculosis in the local population. Demonstration of anti-histone antibodies in similar proportion of SLE patients with and without antecedent anti-TB treatment and similar proportion of renal involvement (36 vs. 40%) between anti-TB drug exposed and non-exposed patients ruled out the drugs to be causative factors in precipitating SLE in these patients with antecedent history of tuberculosis. A cohort of 30 confirmed pulmonary tuberculosis patients were also studied in parallel to demonstrate high incidence of autoantibodies in these patients but no SLE. This study suggests a role of prior tuberculosis in precipitating SLE in genetically predisposed patients.
Department of Immunology and Autoimmunedisorders, National Institute of Immunohaematology (ICMR), 13 Th Fl KEM Hospital Campus, Parel, Mumbai, 400 012, India. kanjakshaghosh@hotmail.com
Kanjaksha
K
Ghosh
Manisha
M
Patwardhan
Vandana
V
Pradhan
D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001323:Autoantibodies; D015551:Autoimmunity; D002648:Child; D015331:Cohort Studies; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D009164:Mycobacterium Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D009169:Mycobacterium tuberculosis / Q000276:immunology; D015995:Prevalence; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*
D000995:Antitubercular Agents; D001323:Autoantibodies