Droz Nina, De Lauzanne Agathe, Holvoet Laurent, Missud Florence, Benkerrou Malika, Brousse Valentine, Odièvre Marie-Hélène, Faye Albert, Koehl Berengere
Robert Debré Hospital, F-75019, Paris, France.
Pediatric Emergency Department, Louis Mourier Hospital, 178 rue des Renouillet, 92700, Colombes, France.
Eur J Pediatr. 2017 Jun;176(6):723-729. doi: 10.1007/s00431-017-2905-0. Epub 2017 Apr 11.
Tuberculosis (TB) and sickle cell anaemia (SCA) may affect the same population of patients, particularly in Africa but also in high-TB incidence areas in developed countries. However, few data are available from children with SCA who develop TB. The aim of this study was to describe the clinical features and outcome of TB diagnosed in children with SCA. We conducted a retrospective, descriptive study in three referral centre of Sickle Cell Disease in Paris, France. We included 11 patients with SCA who develop TB. The median age at TB diagnosis was 11 years [7.5-14.5]. Two patients were asymptomatic and nine patients were symptomatic. Six patients had pulmonary TB (pulmonary, pleural and mediastinal lesions). Five patients had extrapulmonary TB (osteoarticular TB, hepatic TB, cervical and mediastinal TB). Mycobacterium tuberculosis was isolated in four of the 11 cases. All patients recovered after a median of 6 months of anti-TB treatment. The localisation of TB and outcome after treatment in our SCA patients were similar to the one observed in an age-and sex-matched control group of non-SCA patient with TB.
despite the low number of patients included in our study, SCA does not seem to be a risk factor for severe TB. What is Known: • Tuberculosis (TB) remains a global health problem particularly in developing countries, and Sickle cell anaemia (SCA) is currently one of the most common genetic diseases in the world that mainly affects African populations. • Very few data are available on TB in SCA patients. What is New: • The features of TB in children with SCA seem to be comparable to those expected in general population, with favourable outcomes in response to standard treatment. • Monitoring the dosage of anti-TB treatments could be of interest because of the possible impact of SCA on drug metabolism.
结核病(TB)和镰状细胞贫血(SCA)可能影响同一类患者群体,尤其是在非洲,在发达国家结核病高发地区也是如此。然而,关于患结核病的镰状细胞贫血患儿的数据很少。本研究的目的是描述镰状细胞贫血患儿诊断出结核病的临床特征和转归。我们在法国巴黎的三个镰状细胞病转诊中心进行了一项回顾性描述性研究。我们纳入了11例患结核病的镰状细胞贫血患者。结核病诊断时的中位年龄为11岁[7.5 - 14.5]。2例患者无症状,9例患者有症状。6例患者患有肺结核(肺部、胸膜和纵隔病变)。5例患者患有肺外结核(骨关节结核·肝结核、颈部和纵隔结核)。11例病例中有4例分离出结核分枝杆菌。所有患者在接受中位6个月的抗结核治疗后康复。我们的镰状细胞贫血患者中结核病的定位和治疗后的转归与在年龄和性别匹配的非镰状细胞贫血结核病对照组中观察到的情况相似。
尽管我们研究纳入的患者数量较少,但镰状细胞贫血似乎不是严重结核病的危险因素。已知信息:• 结核病仍然是一个全球健康问题,尤其是在发展中国家,镰状细胞贫血是目前世界上最常见的主要影响非洲人群的遗传疾病之一。• 关于镰状细胞贫血患者结核病的数据非常少。新发现:• 镰状细胞贫血患儿结核病的特征似乎与一般人群预期的特征相当,对标准治疗反应良好。• 由于镰状细胞贫血可能对药物代谢有影响,监测抗结核治疗的剂量可能是有意义的。