Latent Tuberculosis Infection in Mexican Children with Rheumatic Diseases

Plascencia, Arturo; Hernández, I Sánchez; Gutiérrez, Susana Borroto; Luévanos, A; Juárez, C; Sandoval, Micaela; Pérez, HR; Plascencia, Miguel R. O.; E, González Ochoa; Armas, Yaxsier de

doi:10.15761/cmid.1000111

Cited by 3 publications

(9 citation statements)

References 7 publications

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“…pregnancy and also the placenta accreta 14,15 . In a woman with placenta praevia in the first pregnancy the risk of developing placenta praevia is 1-3% in contrast to a multigravida where the risk is 30-51% higher 16 .…”

Section: Research Articlementioning

confidence: 99%

Maternal and neonatal outcome in placenta praevia and adherent placenta: A retrospective study in a tertiary care center

Shivananjaiah¹,

Malapure²,

Shanbhag³

et al. 2018

OBGYN

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Objective: The study was conducted to see the maternal and neonatal outcomes of the women with placenta praevia. Methods: All women with the diagnosis of placenta praevia admitted in the hospital were included in the study. The maternal and fetal outcomes were recorded from January 2012 to August 2017, over a period of 5 years. Results: A total of 63 patients were included in the study, after radiological confirmation. The period of gestation for the first presentation was predominantly in 28 weeks of gestation, for central placenta praevia. The mean blood loss intraoperative was 3000 ml, ranging to as much as 5500 ml in central placenta praevia and more so in posterior than anterior placenta. The need of additional procedure like uterine artery ligation was needed in 26 (41.2%), internal iliac artery ligation 8 (12.6%), B lynch in 12 (19.04%) and peripartum hysterectomy was performed in 3 (4.7%). The mean requirement of blood transfusion was 500ml of packed cell. The need of ICU care was in 5 (7.9%) and serious morbidity was seen in 3 (4.7%). Maternal mortality was not seen in any case. Fetal outcomes were studied by recording the fetal weight, Apgar and need of NICU care which was for 23 (36.5%). Conclusion: The need for early diagnosis and multispecialty approach to a patient is greatly associated with reducing the blood loss, lesser need of additional procedure and lower maternal and fetal mortality and morbidity.Keywords: Placenta praevia, accreta, antepartum hemorrhage, maternal complication.Placenta praevia means the placenta located in the lower uterine segment which is less than 2.5 cms from the cervical os 1 . This condition is complicating about 0.3 to 0.8% of all pregnancy 2-5 . The risk factors for developing placenta praevia are previously scarred uterus, grand multiparty, maternal age of more than 35 years, recurrent abortion and intrauterine curettage 6-9 .Maternal morbidity in the form of abnormal placentation, increased risk of section and additional procedure, need for blood transfusion and ICU care and fetal morbidity in the form of preterm, low birth weight, low Apgar and need for NICU care makes it a must for care in a higher center and with available advanced resources [10][11][12][13] . The most frequent management in the form of section which is on the rise in today's era more so increases the risk of placenta praevia in the next RESEARCH ARTICLE

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Section: Research Articlementioning

confidence: 99%

Maternal and neonatal outcome in placenta praevia and adherent placenta: A retrospective study in a tertiary care center

Shivananjaiah¹,

Malapure²,

Shanbhag³

et al. 2018

OBGYN

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“…41 The World Health Organization defines latent Mycobacterium tuberculosis infection or latent TB infection (LTBI) as a state of persistent immune response to stimulation by Mycobacterium tuberculosis (M. tb) antigens without evidence of clinical manifestations of active TB. 1,42 In cases of LTBI, despite the absence of symptoms, there is a risk that patients with rheumatic diseases will develop TB disease, especially in the first two years after the primary infection. 1,42,43 If LTBI is not diagnosed and treated appropriately, activation occurs in 5-10% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…1,42 In cases of LTBI, despite the absence of symptoms, there is a risk that patients with rheumatic diseases will develop TB disease, especially in the first two years after the primary infection. 1,42,43 If LTBI is not diagnosed and treated appropriately, activation occurs in 5-10% of cases. 1,42,43 There are two tests available for the diagnosis of LTBI, the tuberculin skin test (TST), and the interferon-gamma release assay tests (IGRAs).…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis in children and adolescents with rheumatic diseases using biologic agents: an integrative review

Lima

Aurílio

Fonseca

et al. 2024

Rev. paul. pediatr.

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Objective: To conduct a bibliographic review on tuberculosis (TB) disease in children and adolescents with rheumatic diseases, being managed with biologic therapy. Data source: An integrative review with a search in the U.S. National Library of Medicine and the National Institutes of Health (PubMed) using the following descriptors and Boolean operators: ([“tuberculosis”] AND ([“children”] OR [“adolescent”]) AND [“rheumatic diseases”] AND ([“tumor necrosis factor-alpha”] OR [“etanercept”] OR [“adalimumab”] OR [“infliximab”] OR [“biological drugs”] OR [“rituximab”] OR [“belimumab”] OR [“tocilizumab”] OR [“canakinumab”] OR [“golimumab”] OR [“secukinumab”] OR [“ustekinumab”] OR [“tofacitinib”] OR [“baricitinib”] OR [“anakinra”] OR [“rilonacept”] OR [“abatacept”]), between January 2010 and October 2021. Data synthesis: Thirty-seven articles were included, with the total number of 36,198 patients. There were 81 cases of latent tuberculosis infection (LTBI), 80 cases of pulmonary tuberculosis (PTB), and four of extrapulmonary tuberculosis (EPTB). The main rheumatic disease was juvenile idiopathic arthritis. Among LTBI cases, most were diagnosed at screening and none progressed to TB disease during follow-up. Of the TB cases using biologics, most used tumor necrosis factor-alpha inhibitors (anti-TNFα) drugs. There was only one death. Conclusions: The study revealed a low rate of active TB in pediatric patients using biologic therapy. Screening for LTBI before initiating biologics should be done in all patients, and treatment, in cases of positive screening, plays a critical role in preventing progression to TB disease.

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“…Identifying the sensitivity and specificity of TST and IGRAs in the diagnosis of LTBI represents a great difficulty, because in that setting there is not a comparative "gold standard test"; on the other hand, it is easier to define them for active tuberculosis, by having more specific elements and benchmarking objectives such as MTB cultures or molecular tests such as the MTB-Xpert MTB-RIF assay, or the combination of a TB-compatible clinical picture with findings in imaging studies, positive Ziehl–Neelsen staining smears and/or histological studies. However, the sensitivity and specificity of both tests (TST and QFT) in the pediatric population has been compared in several investigations [ 6 , 19 – 22 ]. The TST showed a lower sensitivity of 78% and a specificity of 49%, while the QFT test had a sensitivity of 89% and a specificity of 96% for LTBI.…”

Section: Discussionmentioning

confidence: 99%

“…The TST showed a lower sensitivity of 78% and a specificity of 49%, while the QFT test had a sensitivity of 89% and a specificity of 96% for LTBI. The latter has a lower percentage of false positives related to BCG vaccination and cross-reaction with other mycobacteria; better tolerability among children; greater speed and accuracy in the results [ 16 – 18 , 20 , 22 ]. In our study, we found a higher proportion of QFT positivity compared to TST, both in the general casuistry and in the different subgroups analyzed (age, history of BCG vaccination, contacts of active TB cases and immune status categories.…”

Section: Discussionmentioning

confidence: 99%

A prevalence study in Guadalajara, Mexico, comparing tuberculin skin test and QuantiFERON-TB Gold In-Tube

et al. 2022

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Background Tuberculosis (TB) is a prevalent disease throughout the world. The extent of TB illness in childhood is not clear; recent data shows that 10–20% of the cases are found in children under 15 years old. In 2017, 1 million children developed the disease, of which 9% were co-infected with HIV. Methods A cross-sectional study that analyzed 48 children diagnosed with HIV-infection in Guadalajara, Mexico. The tuberculin skin test (TST) and QuantiFERON-TB Gold In-Tube test (QFT) were performed and compared to diagnose latent TB infection (LTBI). Results The average age was 9 years old (± 4), with an age range of 1–16 years; the 6-12-year-old group predominated with 50% of cases. 27 patients (56%) were male; 83% had received the BCG vaccination and 23% had a history of being contacts of TB cases. In the study, 40 patients (83%) were without immunosuppression; seven (15%) with moderate immunosuppression, and only one patient had severe immunodeficiency. Overall, 3 of the 48 children (6.2%) had a positive TST, while 8 out of 48 (16.6%) had a positive QFT. The concordance between the two tests was 89.6% (43/48) with Kappa = 0.5 (95% CI, 0.14–0.85). Conclusions The QFT test represents an opportunity in the diagnosis of LTBI, particularly in pediatric HIV- patients. This is the first study that compares the two tests (TST and QFT) in children with HIV-infection in Guadalajara, Mexico.

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Latent Tuberculosis Infection in Mexican Children with Rheumatic Diseases

Cited by 3 publications

References 7 publications

Maternal and neonatal outcome in placenta praevia and adherent placenta: A retrospective study in a tertiary care center

Maternal and neonatal outcome in placenta praevia and adherent placenta: A retrospective study in a tertiary care center

Tuberculosis in children and adolescents with rheumatic diseases using biologic agents: an integrative review

A prevalence study in Guadalajara, Mexico, comparing tuberculin skin test and QuantiFERON-TB Gold In-Tube

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