Mycobacterium tuberculosis infection precipitates SLE in patients from endemic areas

Rheumatol Int. 2009 Jul;29(9):1047-50. doi: 10.1007/s00296-009-0903-x. Epub 2009 Apr 10.

Abstract

In a cohort of 70 systemic lupus erythematosus (SLE) patients diagnosed over 2 years period, 14 patients were found to have confirmed antecedent tuberculosis (20.0%) which was 40 times higher (p < 0.001, 95%CI 36.2-48.6) than the prevalence of tuberculosis in the local population. Demonstration of anti-histone antibodies in similar proportion of SLE patients with and without antecedent anti-TB treatment and similar proportion of renal involvement (36 vs. 40%) between anti-TB drug exposed and non-exposed patients ruled out the drugs to be causative factors in precipitating SLE in these patients with antecedent history of tuberculosis. A cohort of 30 confirmed pulmonary tuberculosis patients were also studied in parallel to demonstrate high incidence of autoantibodies in these patients but no SLE. This study suggests a role of prior tuberculosis in precipitating SLE in genetically predisposed patients.

MeSH terms

  • Adolescent
  • Adult
  • Antitubercular Agents / therapeutic use
  • Autoantibodies
  • Autoimmunity
  • Child
  • Cohort Studies
  • Endemic Diseases*
  • Female
  • Humans
  • Incidence
  • India / epidemiology
  • Lupus Erythematosus, Systemic / diagnosis
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / epidemiology*
  • Lupus Erythematosus, Systemic / etiology*
  • Male
  • Mycobacterium Infections / diagnosis
  • Mycobacterium Infections / drug therapy
  • Mycobacterium Infections / epidemiology*
  • Mycobacterium tuberculosis / immunology
  • Prevalence
  • Tuberculosis / diagnosis
  • Tuberculosis / drug therapy
  • Tuberculosis / epidemiology*

Substances

  • Antitubercular Agents
  • Autoantibodies