Uveíte por tuberculose em um centro de referência no Sudeste do Brasil

Abstract

Objective: To describe the occurrence of tuberculous uveitis (TBU) at a referral center in the state of Minas Gerais, Brazil. Methods: A total of 16 consecutive patients (≥15 years of age) who underwent diagnostic evaluation of uveitis between January of 2001 and July of 2004 at the Minas Gerais State Referral Center were selected for study. Demographic and clinical data, as well as data related to screening for toxoplasmosis, syphilis, and rheumatologic diseases, together with the results of tuberculin skin testing and HIV testing, were collected. Results: Of the16 patients evaluated, 11 (69%) were found to have TBU. A history of contact with pulmonary tuberculosis was reported by 8 (72%) of the 11 patients with TBU and by 1 (20%) of the 5 with non-TBU. Although the odds ratio for this association was 10.67 (95% CI: 0.59-398.66), the p value was borderline significant (p = 0.078). There was no difference between the patients with TBU and those with non-TBU in terms of the status of ocular inflammation or the tuberculin skin testing results. All of the patients were HIV negative and were monitored for two years. Conclusion: In this study, a history of contact with pulmonary tuberculosis proved to be useful in diagnosing TBU.Keywords: Tuberculosis; Uveitis; Diagnosis; Brazil. ResumoObjetivo: Descrever a ocorrência de uveíte por tuberculose (UTB) em um centro de referência em Minas Gerais, Brasil. Métodos: Um total de 16 pacientes (idade ≥ 15 anos) atendidos consecutivamente de janeiro de 2001 a julho de 2004 no Centro de Referência de Uveíte do Estado de Minas Gerais para avaliação diagnóstica de uveíte foi selecionado para este estudo. Foram coletados dados demográficos e clínicos, assim como dados sobre avaliação para toxoplasmose, sífilis e doenças reumatológicas, teste tuberculínico e sorologia anti-HIV. Resultados: Dos 16 pacientes, 11 (69%) tinham UTB. História prévia de contato com tuberculose pulmonar foi relatada por 72% (8/11) dos pacientes do grupo com UTB e por 20% (1/5) dos pacientes do grupo sem UTB. Embora a razão de chances para essa associação tenha sido de 10,67 (IC95%: 0,59-398,66), o valor de p apresentou significância limítrofe (0,078). Não houve diferença quanto ao quadro ocular inflamatório e ao resultado do teste tuberculínico entre os pacientes com UTB e os sem UTB. Todos os pacientes tinham sorologia negativa para o HIV e foram acompanhados por 2 anos. Conclusão: Neste estudo, a história prévia de contato com tuberculose pulmonar foi de grande ajuda para o diagnóstico da UTB. Demographic and clinical data, as well as data regarding screening for toxoplasmosis, syphilis, and rheumatologic diseases, together with the results of tuberculin skin testing (TST) and HIV testing, were collected for all patients, except for 1 patient who was a minor (15 years of age). These data were recorded on individual data collection forms and entered into a computer database.In the statistical analysis, the Student's t-test was used for continuous variables of normal distribution, whereas the chi-sq...

The Collaborative Ocular Tuberculosis Study (COTS)-1: A Multinational Review of 447 Patients with Tubercular Intermediate Uveitis and Panuveitis

“…Although from this retrospective analysis it appeared that the addition of ATT to topical therapy does not significantly affect the treatment outcome of TAU patients, different single centers studies reported a therapeutic role of ATT in patients with TAU. 2,6,23,24,[26][27][28][29][30][31][32][33][34][35][36][37][38][39] In addition, from COTS consensus guidelines (unpublished data) it emerged that experts are keen to start ATT in TAU in case of recurrent episodes in patients with one immunological evidence of TB, together with radiological findings suggestive of active or healed pulmonary TB, irrespective of patient's endemicity. In case of first episode of TAU, experts are inclined to initiate ATT in patients with both immunological and radiological tests positive, coming from both endemic and non endemic region.…”