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corticosteroids therapy in tuberculosis

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https://www.readbyqxmd.com/read/29318438/presumed-tuberculous-uveitis-in-a-university-based-tertiary-referral-center-in-saudi-arabia
#1
Awad Al-Qarni, Marwan A Abouammoh, Abdullah N Almousa, Ahmed Mousa, Ahmed M Abu El-Asrar
PURPOSE: To describe clinical characteristics and outcomes of treatment in patients with presumed tuberculous uveitis (PTU). METHODS: All patients diagnosed with PTU between January 1996 and March 2013 were reviewed. The diagnosis was made when clinical findings were consistent with possible intraocular tuberculosis, strongly positive purified protein derivative (PPD) skin test result, and response to anti-tuberculous therapy with no other cause of uveitis as suggested by history, symptoms, or ancillary testing...
January 9, 2018: International Ophthalmology
https://www.readbyqxmd.com/read/29216851/what-does-igra-testing-add-to-the-diagnosis-of-ocular-tuberculosis-a-bayesian-latent-class-analysis
#2
Rupesh Agrawal, Robert Grant, Bhaskar Gupta, Dinesh Visva Gunasekeran, Julio J Gonzalez-Lopez, Peter K F Addison, Mark Westcott, Carlos E Pavesio
BACKGROUND: To evaluate the contribution made to the diagnostic work-up for patients with suspected ocular tuberculosis (TB) by QuantiFERON-TB Gold In-Tube (QFT) tests using latent class analysis model. METHODS: A single centre retrospective cohort study. A Bayesian latent class model was constructed on the basis of demographics, phenotypes and test results from patients attending a tertiary referral center in the UK. This estimated the probability of ocular TB for each patient in two versions, first with and then without QFT...
December 8, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/29201630/avoidance-of-harm-from-treatment-for-anca-associated-vasculitis
#3
REVIEW
Catherine King, Lorraine Harper
Purpose of review With established immunosuppressant treatment regimens for anti-neutrophil cytoplasm antibody-associated vasculitides (AAV), prognosis has significantly improved. The mainstay of treatment still comprises high-dose corticosteroids and cyclophosphamide for severe forms, although rituximab is being increasingly utilised instead of cyclophosphamide as induction therapy. AAV patients experience an excess of infections, malignancies and cardiovascular events as compared to the general population, which is a combination of the systemic inflammatory process associated with vasculitis and the adverse events from treatment...
2017: Current Treatment Options in Rheumatology
https://www.readbyqxmd.com/read/29175527/factors-that-contribute-to-indeterminate-results-from-the-quantiferon-tb-gold-in-tube-test-in-patients-with-inflammatory-bowel-disease
#4
Manreet Kaur, Prianka Singapura, Neeharika Kalakota, Guillermina Cruz, Richa Shukla, Sidra Ahsan, Aylin Tansel, Aaron P Thrift, Hashem B El-Serag
BACKGROUND & AIMS: The QuantiFERON-tuberculosis gold in-tube (QFT-GIT) test is widely used to screen for latent Mycobacterium tuberculosis infection in patients with inflammatory bowel diseases (IBD) before treatment with a tumor necrosis factor antagonist. The test frequently produces indeterminate results, prompting additional testing. We evaluated factors associated with indeterminate results from the QTF-GIT test among patients with IBD. METHODS: We conducted a case-control study among eligible adults with QTF-GIT test results and a concomitant diagnosis of IBD receiving care at a tertiary referral center from 2011 through 2013...
November 23, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29152599/a-novel-clinical-sign-in-intraocular-tuberculosis-active-chorioretinitis-within-chorioretinal-atrophy
#5
Avinash Pathengay, Bhavik Panchal, Himadri Choudhury, Soumyava Basu, Nidhi Relhan, Harry W Flynn
Purpose: To report a novel clinical sign in patients with intraocular tuberculosis. The current study is an observational consecutive case series of patients diagnosed with intraocular tuberculosis managed at a tertiary eye care centre from June 1, 2012 to December 31, 2015. Observations: The diagnosis of intraocular tuberculosis was made in 6 patients based on ocular features suggestive of tuberculosis along with a positive tuberculin skin testing and chest X-ray consistent with tuberculosis...
September 2017: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29117661/a-rare-case-of-infectious-multifocal-serpiginoid-choroiditis
#6
Miloš Mitrašević, Svetlana Jovanović, Filip Radotić, Snežana Pešić, Zorica Jovanović
Multifocal serpiginoid choroiditis is an infectious variety of serpiginous choroiditis. The disease is characterized by infectious etiology and overlapping clinical features in an intermediary form of acute posterior multifocal placoid pigment epitheliopathy and serpiginous choroiditis. In a 33-year-old patient, bilateral multiple placoid partially confluent chorioretinal lesions were diagnosed after a febrile flu-like episode. On the right eye, there was a progressive decrease in visual acuity. Later, the lesions had a prolonged progressive devastating clinical course and widespread distribution of placoid lesions, and took the form of serpiginoid choroiditis...
December 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29075752/clinical-features-and-outcomes-of-patients-with-tubercular-uveitis-treated-with-antitubercular-therapy-in-the-collaborative-ocular-tuberculosis-study-cots-1
#7
Rupesh Agrawal, Dinesh Visva Gunasekeran, Robert Grant, Aniruddha Agarwal, Onn Min Kon, Quan Dong Nguyen, Carlos Pavesio, Vishali Gupta
Importance: Eradication of systemic tuberculosis (TB) has been limited by neglected populations and the HIV pandemic. Whereas ocular TB often presents as uveitis without any prior evidence of systemic TB, the existing uncertainty in the diagnosis of TB uveitis may perpetuate missed opportunities to address systemic TB. Objective: To examine the clinical features of TB uveitis and the associations with response to antitubercular therapy (ATT). Design, Setting, and Participants: This retrospective multinational cohort study included patients from 25 ophthalmology referral centers diagnosed with TB uveitis and treated with ATT from January 1, 2004, through December 31, 2014, with a minimum follow-up of 1 year...
December 1, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/29027603/review-of-people-with-retinal-vasculitis-and-positive-quantiferon-%C3%A2-tb-gold-test-in-an-area-nonendemic-for-tuberculosis
#8
David R Brunner, Sandrine A Zweifel, Daniel Barthelmes, Fabio Meier, Christian Böni
PURPOSE: To assess the frequency of a positive QuantiFERON(®)-TB Gold test (quantiferon) among patients with retinal vasculitis in an area nonendemic for tuberculosis (TB); to review clinical characteristics and management of affected individuals. METHODS: Consecutive patients with retinal vasculitis and a positive quantiferon were retrospectively analyzed. Demographics, clinical data, laboratory, imaging findings, and therapy were evaluated. RESULTS: Among 49 patients with retinal vasculitis, 12 (24%) had a positive quantiferon...
October 13, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/29020496/clinical-outcomes-of-adjunctive-sustained-release-intravitreal-dexamethasone-implants-in-tuberculosis-associated-multifocal-serpigenoid-choroiditis
#9
Lubhani Jain, Krushna Gopal Panda, Soumyava Basu
PURPOSE: To analyze the safety and efficacy of sustained-release intravitreal dexamethasone implant (Ozurdex) in management of TB-associated multifocal serpiginoid choroiditis (MSC). METHODS: Retrospective review of TB-associated MSC patients, treated with anti-TB therapy (ATT) and adjunctive intravitreal Ozurdex. RESULTS: Nine eyes of six patients were included. Four patients required Ozurdex implant for progressive or new lesions following ATT and two for additional systemic contraindications to corticosteroids - hyperglycemia and uncontrolled hypertension, respectively...
October 11, 2017: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/28986117/screening-prophylaxis-and-counselling-before-the-start-of-biological-therapies-a-practical-approach-focused-on-ibd-patients
#10
REVIEW
Cândida Abreu, António Sarmento, Fernando Magro
The standard of care in the management of immune-mediated inflammatory conditions relies on immunomodulators, glucocorticoids, and biologicals (including anti-tumour necrosis factor -α and other monoclonal antibodies). These agents have an overall favourable benefit/risk ratio; however, they modulate the immune response as part of their mechanisms of action, and therefore they may increase the risk of developing infections, particularly in older patients or in patients with concomitant corticosteroids. Some of these infections may be preventable by immunization, chemoprophylaxis or counselling...
December 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28980216/tuberculous-uveitis-association-between-anti-tuberculous-therapy-and-clinical-response-in-a-non-endemic-country
#11
Kristina L Bajema, Kaivon Pakzad-Vaezi, Thomas Hawn, Kathryn L Pepple
BACKGROUND: The study aims to report the association between successful uveitis control following anti-tuberculous therapy (ATT) for uveitis associated with a positive tuberculosis (TB) screening test in a low endemic setting. A retrospective chart review of cases between 2010 and 2017 at a tertiary uveitis referral center in the United States of America was conducted. Subjects with any form of uveitis, a positive TB interferon-gamma release assay or tuberculin skin test, and negative evaluation for other causes of uveitis were included...
October 4, 2017: Journal of Ophthalmic Inflammation and Infection
https://www.readbyqxmd.com/read/28932979/tuberculous-meningitis-in-children-and-adults-new-insights-for-an-ancient-foe
#12
REVIEW
Alyssa Mezochow, Kiran Thakur, Christopher Vinnard
PURPOSE OF REVIEW: Tuberculous meningitis is the most devastating manifestation of infection with Mycobacterium tuberculosis and represents a medical emergency. Approximately one half of tuberculous meningitis patients die or suffer severe neurologic disability. The goal of this review will be to review the pathogenic, clinical, and radiologic features of tuberculous meningitis and to highlight recent advancements in translational and clinical science. RECENT FINDINGS: Pharmacologic therapy includes combination anti-tuberculosis drug regimens and adjunctive corticosteroids...
September 20, 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28884751/tuberculous-meningitis
#13
REVIEW
Robert J Wilkinson, Ursula Rohlwink, Usha Kant Misra, Reinout van Crevel, Nguyen Thi Hoang Mai, Kelly E Dooley, Maxine Caws, Anthony Figaji, Rada Savic, Regan Solomons, Guy E Thwaites
Tuberculosis remains a global health problem, with an estimated 10.4 million cases and 1.8 million deaths resulting from the disease in 2015. The most lethal and disabling form of tuberculosis is tuberculous meningitis (TBM), for which more than 100,000 new cases are estimated to occur per year. In patients who are co-infected with HIV-1, TBM has a mortality approaching 50%. Study of TBM pathogenesis is hampered by a lack of experimental models that recapitulate all the features of the human disease. Diagnosis of TBM is often delayed by the insensitive and lengthy culture technique required for disease confirmation...
October 2017: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/28883243/an-hiv-positive-case-of-obstructive-jaundice-caused-by-immune-reconstitution-inflammatory-syndrome-of-tuberculous-lymphadenitis-successfully-treated-with-corticosteroids
#14
Naoaki Watanabe, Ryota Sato, Hideaki Nagai, Hirotoshi Matsui, Akira Yamane, Masahiro Kawashima, Junko Suzuki, Hiroyuki Tashimo, Nobuharu Ohshima, Kimihiko Masuda, Atsuhisa Tamura, Shinobu Akagawa, Akira Hebisawa, Ken Ohta
A 60-year-old man was admitted to our hospital because of a persistent fever with enlargement of multiple lymph nodes in the mediastinum and around the pancreatic head. He was diagnosed with tuberculosis and human immunodeficiency virus infection. We started antiretroviral therapy three weeks after the initiation of anti-tuberculous therapy. Two weeks later, jaundice appeared with dilatation of the biliary tract due to further enlargement of the lymph nodes, which seemed to be immune reconstitution inflammatory syndrome (IRIS)...
October 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28767612/pyoderma-gangrenosum-in-a-patient-with-chronic-granulomatous-disease-a-case-report
#15
Sideris Nanoudis, Afroditi Tsona, Olga Tsachouridou, Petros Morfesis, Georgia Loli, Adamantini Georgiou, Pantelis Zebekakis, Symeon Metallidis
RATIONALE: The simultaneous occurrence of pyoderma gangrenosum (PG) and chronic granulomatous disease (CGD) is uncommon and few cases have been reported worldwide. PATIENT CONCERNS: PG is a rare, chronic, ulcerative, neutrophilic skin disease of unknown etiology that requires immunosuppressive treatment. CGD belongs to Primary Immune Deficiencies in which the main defect lies in an inability of the phagocytic cells to generate superoxide making patients susceptible to serious, potentially life-threatening bacterial and fungal infections...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28714745/long-term-use-of-inhaled-corticosteroids-and-risk-of-upper-respiratory-tract-infection-in-chronic-obstructive-pulmonary-disease-a-meta-analysis
#16
Mingjin Yang, Hong Chen, Yan Zhang, Yuejun Du, Ying Xu, Ping Jiang, Zhibo Xu
Recent studies have suggested that inhaled corticosteroids (ICS) may be associated with higher risks of tuberculosis and pneumonia in patients with COPD. However, it is not known whether ICS increases the risk of upper respiratory tract infection (URTI). Aim of this study was to explore the relationship between ICS and URTI. Through a comprehensive literature search of PubMed, EMBASE, Cochrane Library, and Google Scholar from inception to March 2016, we identified randomized controlled trials of ICS therapy lasting at least 6 months...
April 2017: Inhalation Toxicology
https://www.readbyqxmd.com/read/28690859/case-report-of-a-lupus-patient-with-a-severe-flare-and-miliary-tuberculosis-need-for-proper-guidelines-for-management
#17
Masooma Hashmat, Ramsa Suhail Rana, Tafazzul-E-Haque Mahmud, Aflak Rasheed, Ata Ur Rehman, Syed Ali Rukh Pirzada, Muhammad Ammad Asghar, Sadia Asif, Amjad Ali
Systemic lupus erythematosus (SLE) is an autoimmune disease that is frequently treated with high doses of corticosteroids and other immunosuppressive drugs. Thus patients with SLE are at increased risk for infections with several pathogens including Mycobacterium tuberculosis. There are no established guidelines available for treatment of tuberculosis in SLE patients with high disease activity due to lack of relevant studies and management based more on physician expertise. We report a case of a young SLE patient with high disease activity index (SLEDAI19) as evidenced by the presence of a vasculitic rash, non-healing ulcer on forearm and proteinuria of >1 g/d along with miliary tuberculosis...
July 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28670226/management-of-crohn-s-disease-in-taiwan-consensus-guideline-of-the-taiwan-society-of-inflammatory-bowel-disease
#18
REVIEW
Shu-Chen Wei, Ting-An Chang, Te-Hsin Chao, Jinn-Shiun Chen, Jen-Wei Chou, Yenn-Hwei Chou, Chiao-Hsiung Chuang, Wen-Hung Hsu, Tien-Yu Huang, Tzu-Chi Hsu, Chun-Chi Lin, Hung-Hsin Lin, Jen-Kou Lin, Wei-Chen Lin, Yen-Hsuan Ni, Ming-Jium Shieh, I-Lun Shih, Chia-Tung Shun, Yuk-Ming Tsang, Cheng-Yi Wang, Horng-Yuan Wang, Meng-Tzu Weng, Deng-Chyang Wu, Wen-Chieh Wu, Hsu-Heng Yen, Jau-Min Wong
Crohn's disease (CD) is a chronic relapsing and remitting inflammatory disease of the gastrointestinal tract. CD is rare in Taiwan and other Asian countries, but its prevalence and incidence have been steadily increasing. A steering committee was established by the Taiwan Society of Inflammatory Bowel Disease to formulate statements on the diagnosis and management of CD taking into account currently available evidence and the expert opinion of the committee. Thorough clinical, endoscopic, and histological assessments are required for accurate diagnosis of CD...
July 2017: Intestinal Research
https://www.readbyqxmd.com/read/28646434/performance-of-quantiferon%C3%A2-tb-gold-in-tube-assay-in-children-receiving-disease-modifying-anti-rheumatic-drugs
#19
Francesca Gabriele, Maria Trachana, Maria Simitsopoulou, Polixeni Pratsidou-Gertsi, Elias Iosifidis, Zoi Dorothea Pana, Emmanuel Roilides
BACKGROUND: To evaluate the performance of the Quantiferon(®)-TB Gold In-Tube (QFT-IT) interferon (IFN)-γ assay for the detection of latent tuberculosis infection (LTBI) in children receiving anti-rheumatic treatment in a tertiary referral hospital of Northern Greece. METHODS: A total of 79 consecutive children receiving anti-rheumatic treatment [of which 18 screened prior to antitumor necrosis factor (TNF)-α treatment] were tested using Mantoux tuberculin skin test (TST) and QFT-IT...
October 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/28586583/eales-disease
#20
Mohammad Naeem Khan, Syed Shahmeer Raza, Shayan Qadir, Hana Rehman, Amer Kamal Hussain, Muhammad Daniyal Nadeem, Farhan Ullah
Eales disease is an eponym after a British ophthalmologist Henry Eales. The aetiology behind Eales disease is ill-understood and stands controversial. Various systemic diseases associated with peripheral retinal revascularization and Retinal vasculitis could imitate the proliferative and inflammatory phases of Eales' disease, respectively. We present a case of a 30 years old female patient with Eales disease and discuss the clinical features, treatment plan and its outcome in our patient. Tuberculosis appears to be the cause of Eales disease but the relation is yet to be established and clinically proven...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
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