Background:Around 10 million people worldwide contract tuberculosis (TB) every year. According to the World Health Organization (WHO), approximately one-quarter of the world’s population is latently infected with Mycobacterium tuberculosis. Its treatment is extremely long and patients may experience a variety of adverse reactions.Objectives:The aim of this study was to assess the different adverse drug reactions (ADR’s) in patients treated with first-line anti-tubercular drugs.Methods:This retrospective study included 45 cases of TB followed in the Rheumatology department of Farhat Hached hospital in Sousse, Tunisia, over a period of 22 years (1998-2020).Results:The mean age was 52.2 ± 17.72 years [14-95 years]. These were 19 men (42.2%) and 26 women (57.8%).The different locations of tuberculosis were as follows: pulmonary for 5 patients (11.1%), spinal for 26 patients (57.8%), articular for one patient (2.2%), urinary for two (4.4%), and multifocal for 8 patients (17.8%). An anti-tuberculosis treatment (based on quadrytherapy: Rifadine(R), Isoniazide(I), Pyrazinamide (Z) and Ethambutol (E)during 2 months, followed by biotherapy based on (R)and (I) was prescribed for an average duration of 10.85 months [6-24 months]. ADR’s were observed in 53.33% of patients. Abdominal pain and nausea were detected in 5 cases (11.1%). Hepatic cytolyse was noticed in 8 cases (17.8%) under (R). Cholestatic hepatitis occurred in 9 cases (20%) under (R). Asymptomatic Hyperuricemia was detected in 15 cases (33.3%) with (E). Two cases of toxiderma were detected: the first under (E) and the second under (E) + (Z). Ethambutol was responsible for a case of DRESS syndrome and a case of drug-induced hepatitis. One case of hemolytic anemia had occurred under (R). A sensorineural hearing loss was noted under streptomycin in one case. No fatal side effects were observed. These ADR’s were reversible in all cases.Conclusion:The treatment of TB can cause a variety of ADRs’. Early recognition by active surveillance and appropriate management of these ADRs’ might improve adherence and treatment success.References:[1]Prasad, R., Singh, A., & Gupta, N. Adverse drug reactions in tuberculosis and management. Indian Journal of Tuberculosis, 66(4), 520–532 (2019).Disclosure of Interests:None declared
Background:Biologic therapies are emerging as a significant therapeutic option for many with debilitating inflammatory and autoimmune conditions including rheumatoid arthritis (RA).These biological agents are highly effective in RA. Potential complications are dominated by infections.Objectives:To evaluate the different infections occurred under biotherapy.Methods:This is a descriptive retrospective study including patients under biotherapy, hospitalized between 2000-2016 in the Rheumatology Department of Farhat Hached hospital in Sousse,Tunisia. We evaluated for each patient the different infections that have occurred, specifying the different types of biotherapy received.Results:Sixty one patients are included (54 women and 7 men).The average age is 55.33 years ±11.51 [34-81 years].We found 47 infections in 40 patients (65.57%) with at least one infection under biotherapy: 41 women and 6 men with a mean age at 57.72 years [34-81 years]. Infections occurred under anti IL6 in 46.32%, Infliximab in 31.58%, anti CD20 in 11.58%, Etanercept in 7.37% and under Certolizumab in 3.16%. The infection was bacterial in 68.42%: 28 pulmonary infections, 8 oto rhino laryngology infections, 14 urinary infections, 2 soft tissue abscess, 13 cutaneous infections, 02 ocular infections. A viral origin of the infection was noted in 12.63% of cases. As for mycosis infections they represent 18.75% of the etiologies identified. The treatment was medical in 100% of cases and the evolution was favorable in all patients without resorting to the definitive discontinuation of biotherapy.Conclusion:The infections reported in our series are much more frequent under anti IL6 treatment and bacteria are the most incriminating pathogenic agents in our patients.References:[1]Simon, T. A.,and al. Comparative risk of malignancies and infections in patients with rheumatoid arthritis initiating abatacept versus other biologics: a multi-database real-world study. Arthritis Research & Therapy, 21(1).(2019).[2]Pawar, A.,and al Risk of serious infections in tocilizumab versus other biologic drugs in patients with rheumatoid arthritis: a multidatabase cohort study. Annals of the Rheumatic Diseases, annrheumdis–2018–214367(2019).Disclosure of Interests:None declared
Background:Infectious spondylodiscitis is a serious impairment that can compromise the functional and vital prognosis. The determination of the germ responsible is the key of the treatment.Objectives:The objective of our work is to describe the epidemiological, clinical and evolutionary profile according to the germ responsible by comparing tuberculous and brucellar spondylodiscitis.Methods:This is a retrospective study including 32 cases of spondylodiscitis with specific germs (Mycobacterium tuberculosis and Brucella) collected in an internal medicine department over a period of 18 years (2000-2018).Results:These were 20 men and 12 women with an M / F ratio of 1.66. The average age of our patients was 50.63 [16-84]. The germ implicated was Koch’s Bacillus in 11 patients (34.38%) and Brucella in 21 patients (65.63%). The mean age for tuberculosis (TB) was 45.18 years versus 53.48 years for brucellosis. Spinal pain was the major symptom in the 02 groups. The deterioration in general condition was present in 80.95% for the brucellosis group versus 81.82% for the tuberculosis group.Biological inflammatory syndrome was observed in 94.24% of the brucellosis group and 63.63% of the TBC group. The lumbar location was the most frequent in the 02 groups (71.88%).It was a multifocal localization in 27.27% (TB) and 61.90% (Brucellosis) respectively. The imaging allowed the detection of para abscesses -vertebral in 54.55% for the TB group versus 23.81% for the brucellar group. An epiduritis was objectified in 36.36% of the TB group against 33.33% for that of brucellar. CT-guided biopsy was performed in 54.55% of tuberculosis patients compared to 47.62% in the other group. It was only positive in one case of brucellosis, whereas it allowed diagnosis in 36.36% of cases of TB.The evolution after initiation of adequate antibiotic treatment was interspersed with neurological complications in the tuberculosis group in 18.18% of cases against 14.29% in the brucellosis group. Draining abscess was necessary in the tuberculosis group in 18.18% and in 9.52% of the brucellosis cases.Conclusion:Our results show a higher frequency of neurological complications in tuberculosis forms. Vertebral biopsy is of no interest in Brucellar spondylodiscitis unlike tuberculosis forms where it allows the diagnosis.References:[1]Bousson,et al (2014). Infection rachidienne: du germe lent au staphylocoque doré. Revue Du Rhumatisme Monographies, 81(1), 27–35.[2]Bierry, G., & Dietemann, J.-L. (2012). Imagerie des spondylodiscites infectieuses. EMC - Radiologie et Imagerie Médicale - Musculosquelettique - Neurologique - Maxillofaciale, 7(4), 1–16.Disclosure of Interests:None declared
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.