Active and Latent Tuberculosis in Children Treated with Anti-TNF-α: A Retrospective Multicenter Study


Dalgic N., Sahin A., Torun S. H., Kaba O., Onal P., Yilmaz A. T., ...Daha Fazla

JOURNAL OF PEDIATRIC INFECTIOUS DISEASES, cilt.17, sa.2, ss.90-97, 2021 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 17 Sayı: 2
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1055/s-0042-1743195
  • Dergi Adı: JOURNAL OF PEDIATRIC INFECTIOUS DISEASES
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, EMBASE, Veterinary Science Database
  • Sayfa Sayıları: ss.90-97
  • Anahtar Kelimeler: tumor necrosis factor, tuberculosis, children, GAMMA RELEASE ASSAY, SKIN-TEST, YOUNG-CHILDREN, RISK, INFECTION, DIAGNOSIS, TESTS, METAANALYSIS, ANTAGONIST, ARTHRITIS
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet

Özet

Objective This study aimed to investigate the frequency of latent and active tuberculosis (TB) in pediatric patients receiving anti-tumor necrosis factor (TNF)-alpha therapy. Methods Patients younger than 18 years with various inflammatory diseases and treated with anti-TNF-alpha agents in the past five years were included in the study. The patients' ages, follow-ups, medications received, clinical and laboratory findings, and treatments applied were recorded retrospectively. Results Of the 160 patients included in the study, 78 (48.8%) were girls. The mean age was 139.54 +/- 48.74 (30-226) months. Sixty (37.5%) patients had inflammatory eye disease, 55 (34.4%) had rheumatologic and autoimmune disease, and 45 (28.1%) had inflammatory bowel disease. As anti-TNF-alpha treatment, 67 (41.9%) patients received adalimumab, 50 (31.2%) received infliximab, and 43 (26.9%) received etanercept. As a result of TB screening performed prior to the treatment, 44 (25.4%) patients were started on isoniazid treatment with the diagnosis of latent TB. During follow-up, latent TB infection was detected in 16 (9.2%) patients and isoniazid treatment was started. The time to develop latent TB under anti-TNF-alpha treatment ranged from 3 to 28 months. During the treatment, active TB infection developed in two (1.2%) patients and anti-TB treatment was initiated. Conclusion It is of vital importance to evaluate patients receiving, or planned to receive, anti-TNF-alpha treatment, for TB infection and to initiate appropriate treatments if latent or active TB infection is identified.