Colpani Agnese, Astorri Davide, De Vito Andrea, Madeddu Giordano, Panese Sandro, Geremia Nicholas
Unit of Infectious Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy.
Rheumatology Unit, Department of Medicine, Ospedale Civile "S.S. Giovanni e Paolo", 30122 Venice, Italy.
Reports (MDPI). 2024 Sep 24;7(4):82. doi: 10.3390/reports7040082.
: Tuberculosis (TB) poses a significant global health challenge; although low-middle income countries carry the heaviest burden, its diagnosis and treatment can be challenging in any country. The clinical picture can be complex and vary from person to person, with autoimmune complications that can hinder TB diagnosis and treatment. : We report the case of a 38-year-old man from Bangladesh who had recently arrived in Italy through the Balkan route. He presented with TB in the cervical lymph nodes and long-standing chronic myalgias. While a wide range of TB-triggered autoimmune entities can be found in the literature, this case is the first to describe immune-mediated necrotizing myopathy (IMNM) triggered by active TB. : IMNM has been previously associated only with other infections like SARS-CoV-2 and Dengue. The successful diagnosis and management of TB-induced IMNM was achieved through a collaborative, multidisciplinary approach involving rheumatologists, immunologists, and infectious diseases specialists, showcasing an innovative treatment strategy and adding new insights into the complexities of TB and IMNM.
结核病对全球健康构成重大挑战；尽管中低收入国家负担最重，但在任何国家，其诊断和治疗都可能具有挑战性。临床表现可能复杂且因人而异，存在自身免疫并发症，这可能会妨碍结核病的诊断和治疗。我们报告了一名来自孟加拉国的38岁男子的病例，他最近通过巴尔干路线抵达意大利。他表现为颈部淋巴结结核和长期慢性肌痛。虽然文献中可以找到多种由结核病引发的自身免疫性疾病，但该病例是首例描述由活动性结核病引发的免疫介导坏死性肌病（IMNM）的病例。IMNM此前仅与其他感染如SARS-CoV-2和登革热有关。通过风湿病学家、免疫学家和传染病专家合作的多学科方法，成功诊断和管理了结核病诱发的IMNM，展示了一种创新的治疗策略，并为结核病和IMNM的复杂性增添了新的见解。
