Evaluation of tuberculosis frequency in children using biological agents

Authors : Yalçın KARA, Mahmut Can KIZIL, Merve İŞERİ NEPESOV, Aslı KAVAZ TUFAN, Nuran CETIN, Yusuf AYDEMİR, Zeren BARIŞ, Hilal KAYA ERDOĞAN, Ömer KILIÇ, Ener Çağrı DİNLEYİCİ

Pages : 238-246

Doi:10.31362/patd.1189676

View : 12 | Download : 3

Publication Date : 2023-04-05

Article Type : Research Paper

Abstract :Purpose: Anti-TNF drugs increase the risk of tuberculosis. In this study we aimed to investigate the incidence of tuberculosis in patients using anti-TNF drugs. Methods: One hundred and fifteen pediatric cases which were received anti-TNF drugs were included in the study. The clinical and epidemiological characteristics of the cases were analyzed retrospectively. Results: One hundred and fifteen cases using anti-TNF drugs were included in the study. The diagnoses of the cases were as follows; Juvenile Rheumatoid Arthritis 76 insert ignore into journalissuearticles values(66%);, Ulcerative Colitis 11 insert ignore into journalissuearticles values(9.6%);, Crohn\`s 7 insert ignore into journalissuearticles values(6%);, Ankylosing Spondylitis 6 insert ignore into journalissuearticles values(5.2%);, FMF 5 insert ignore into journalissuearticles values(4.3%);, Psoriasis 4 insert ignore into journalissuearticles values(%3.5);. The distribution of the agents used by the patients was; etanercept 74 insert ignore into journalissuearticles values(64.3%);, infliximab 17 insert ignore into journalissuearticles values(14.8%);, adalimumab 17 insert ignore into journalissuearticles values(14.8%);, anakinra 5 insert ignore into journalissuearticles values(4.3%);, and canakinumab 2 insert ignore into journalissuearticles values(%1.7);. It was learned that all cases had BCG vaccinations when they were two months old, confirmed by the vaccination cards and the ministry of health\`s vaccination follow-up system. TST was performed in all of the cases and TST response was measured as <5mm in 89 insert ignore into journalissuearticles values(77.4%);, 5-9 mm in 11 insert ignore into journalissuearticles values(8.7%);, 10-14 mm in 8 insert ignore into journalissuearticles values(7.4%);, >15 mm in 7 insert ignore into journalissuearticles values(5.6%); cases. Isoniazid insert ignore into journalissuearticles values(INH); prophylaxis was started for nine months in 17 cases with the diagnosis of latent tuberculosis. Active tuberculosis was not detected in any of the cases. Conclusion: All patients receiving anti-TNF need to be evaluated for tuberculosis. Although it is not detected at the beginning of the treatment, regular tuberculosis screening should be continued during the treatment with contact history, symptoms, physical examination, chest X-ray, and TST/IGRA in light of current guidelines.
Keywords : tüberküloz, çocuk, anti TNF