Abstract
To investigate the clinical features and potential risk factors of active tuberculosis (ATB) in Behçet's disease (BD), we conducted a case-control study on hospitalized BD patients in our institute from 2010 to 2019. BD patients with ATB were enrolled as the case group. The control group was selected by random number sampling from the remaining BD patients, including those with latent tuberculosis infection, previous tuberculosis, or without tuberculosis. Finally, we reviewed 386 BD patients and identified 21 (5.4%) ATB cases, including four (19.0%) microbiologically confirmed and 17 (81.0%) clinically diagnosed. We found that BD patients with ATB were more prone to have systemic symptoms (fever, night sweating, and unexplained weight loss) and/or symptoms related to the infection site. Multivariate logistic regression analysis revealed that erythrocyte sedimentation rate (ESR) > 60 mm/h (OR = 13.710, 95% CI (1.101, 170.702)), increased IgG (OR = 1.226, 95% CI (1.001, 1.502)), and positive T-SPOT.TB (OR = 7.793, 95% CI (1.312, 48.464), for 24-200 SFC/106PBMC; OR = 17.705 95% CI (2.503, 125.260), for >200 SFC/106PBMC) were potential risk factors for ATB in BD patients. Our study suggested that when BD patients have systemic symptoms with significantly elevated TB-SPOT, the diagnosis of ATB should be considered.
Highlights
Behçet’s disease (BD) is a systemic vasculitis prevalent in the areas along the Ancient Silk Road such as Turkey, Iran, China, and Japan [1]
TB infection may trigger the pathogenesis of BD [6, 7], and BD patients are at high risk of active tuberculosis (ATB) infection [8, 9]
The control group consisted of 69 patients, including 25 (36.2%) with latent tuberculosis infection (LTBI) or previous tuberculosis (PTB) and 44 (63.8%) without TB
Summary
Behçet’s disease (BD) is a systemic vasculitis prevalent in the areas along the Ancient Silk Road such as Turkey, Iran, China, and Japan [1]. In China, the prevalence of BD is estimated to be 14 in 100 000 [2]. It has been noticed that BD is closely related to tuberculosis (TB) [3, 4], which is prevalent in China [5]. TB infection may trigger the pathogenesis of BD [6, 7], and BD patients are at high risk of active tuberculosis (ATB) infection [8, 9]. Once a BD patient is infected with ATB, the immunosuppressive therapy would be reduced or suspended [13], resulting in the BD deterioration and increased risk of developing immune reconstitution inflammatory syndrome [14]. Understanding the clinical features and risk factors of ATB in patients with BD is of great importance
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