Nina Droz1,2, Agathe De Lauzanne3, Laurent Holvoet4,5, Florence Missud4,5, Malika Benkerrou4,5,6, Valentine Brousse7, Marie-Hélène Odièvre8, Albert Faye3,6,9, Berengere Koehl3,9. 1. Robert Debré Hospital, F-75019, Paris, France. Droznina@gmail.com. 2. Pediatric Emergency Department, Louis Mourier Hospital, 178 rue des Renouillet, 92700, Colombes, France. Droznina@gmail.com. 3. Robert Debré Hospital, F-75019, Paris, France. 4. Assistance Publique-Hôpitaux de Paris, Hematology Unit, Robert Debré Hospital, F-75019, Paris, France. 5. Assistance Publique-Hôpitaux de Paris, Reference Centre of Sickle Cell Disease, Robert Debré Hospital, F-75019, Paris, France. 6. INSERM UMR 1123, ECEVE, Paris, France. 7. Assistance Publique-Hôpitaux de Paris, Reference Centre of Sickle Cell Disease, Necker Hospital, Paris, France. 8. Assistance Publique-Hôpitaux de Paris, Pediatric Unit, Louis Mourier Hospital, Colombes, France. 9. Université Paris 7 Denis Diderot, Paris Sorbonne Cité, Paris, France.
Abstract
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. CONCLUSION: 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.
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. CONCLUSION: 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.
Entities:
Keywords:
Children; Drug monitoring; Sickle cell anaemia; Tuberculosis
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