title: How do we manage and treat a patient with multiple sclerosis at risk of tuberculosis?
abstract: Tuberculosis continues to be a serious health problem worldwide. The disease continues to be underdiagnosed and not properly treated. In conditions that affect the immune system, such as multiple sclerosis (MS), latent tuberculosis may thrive and reactivate during the use of immunomodulatory and immunosuppressive drugs. Among the best treatment options for patients with latent or active tuberculosis who have MS are IFN-β, glatiramer acetate and mitoxantrone. Drugs leading to a reduced number and/or function of lymphocytes should be avoided or used with caution. Tuberculosis must always be investigated in patients with MS and treated with rigor.
authors.affiliation: Department of Neurology and MS Reference Center, Universidade Metropolitana de Santos, SP, Brazil.
authors.forename: Yara Dadalti
authors.initials: YD
authors.lastname: Fragoso
authors.forename: Tarso
authors.initials: T
authors.lastname: Adoni
authors.forename: Andrea
authors.initials: A
authors.lastname: Anacleto
authors.forename: Joseph Bruno Bidin
authors.initials: JB
authors.lastname: Brooks
authors.forename: Margarete de Jesus
authors.initials: Mde J
authors.lastname: Carvalho
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Claudino
authors.forename: Alfredo
authors.initials: A
authors.lastname: Damasceno
authors.forename: Maria Lucia Brito
authors.initials: ML
authors.lastname: Ferreira
authors.forename: Paulo Diniz da
authors.initials: PD
authors.lastname: Gama
authors.forename: Marcus Vinicus Magno
authors.initials: MV
authors.lastname: Goncalves
authors.forename: Anderson Kuntz
authors.initials: AK
authors.lastname: Grzesiuk
authors.forename: Andre Palma da Cunha
authors.initials: AP
authors.lastname: Matta
authors.forename: Monica Fiuza Koncke
authors.initials: MF
authors.lastname: Parolin
mesh_terms: D019468:Disease Management; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D009103:Multiple Sclerosis / Q000188:drug therapy*; D014376:Tuberculosis / Q000209:etiology*
chemical_list: D007166:Immunosuppressive Agents
keywords: IFN-β; fingolimod; fumarate; glatiramer acetate; multiple sclerosis; natalizumab; teriflunomide; tuberculosis