Clinical features of pregnancy in multidrug-resistant tuberculosis and type I diabetes mellitus comorbidities (a case report).

Abstract

22. Lusiak M., Podwińska J. Interleukin 10 and its role in the regulation of the cell-mediated immune response in syphilis. Abstract. Clinical features of pregnancy in multidrug-resistant tuberculosis and type I diabetes mellitus comorbidities (a case report). Raznatovska O.M., Fedorec A.V., Shalmina M.O., Grekova T.A.Objective -to update the literature data with the clinical features of pregnancy in multidrug-resistant tuberculosis (MRD-TB) and type 1 diabetes mellitus (T1DM) comorbidities based on an example from own clinical experience. A clinical case of pregnancy course in MRD-TB and T1DM comorbidities was described based on our own clinical experience. We report the clinical case of newly diagnosed MRD-TB in a 38-year-old woman suffering from T1DM. Her general condition was unstable from satisfactory to moderately severe despite an adequate treatment of MRD-TB and T1DM with manifestations of intoxication syndrome and nephropathy. Adenomyosis with periodic bloody vaginal discharge was diagnosed. There was no clinical-radiological dynamics and sputum culture conversion. After an intensive phase of antimycobacterial therapy within 3 months, the patient got pregnant. Based on the medical indications (MRD-TB, absence of sputum culture conversion and clinical-radiological dynamics, moderate severity of T1DM, nephropathy) and adenomyosis with bloody vaginal discharge, the patient was requested to induce the pregnancy termination, and she consented. On month 7 of antimycobacterial therapy, an extensive drug-resistance of Mycobacterium tuberculosis

Examining family planning and adverse pregnancy outcomes for women with active tuberculosis disease: a systematic review

“…In regard to TB outcomes, the majority of women in cases reported treatment completion, cure or improvement of clinical symptoms. 23–25 38 39 45 50–52 58 59 63–69 72–75 78 80 Other TB-related maternal outcomes included deaths, 19 21 28 30 32 33 36 41 42 47–49 56 81 82 lost to follow-up, 41 83 TB treatment failure 57 or unknown. 18 22 26 44 Across 16 case series, 19 29 49 53 61 76 77 81 83 a case-control study 41 and cohort studies 31 33 42 62 82 84 that provided descriptive data of TB outcomes, there were a total of 402 cases.…”

“… 33 Four studies reported successful treatment outcome (complete or cure) for the majority of their samples (83.3%, 61%, 65.4% and 88%) and lost to follow-up (11.1%, 28.6%, 26.9% and 12%). 42 62 82 84 The remaining studies, three case reports 57 72 78 and a case series, 19 provide conflicting results on maternal and fetal outcomes: two case studies reported good outcome for mother and baby, one case study reported treatment failure with induced abortion, while the case series noted maternal and fetal/newborn complications and deaths in their descriptive analysis. The validity and generalisability of these studies are limited by their study design and sample size.…”