https://doi.org/10.4081/reumatismo.2025.1631
Tuberculosis infection in patients with dermatomyositis
Submitted: 8 August 2023
Accepted: 25 October 2024
Published: 7 March 2025
Accepted: 25 October 2024
Abstract Views: 28
PDF: 14
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Patients with dermatomyositis (DM) are particularly susceptible to the development of opportunistic infections due to immunosuppression induced by the disease itself and its treatment. We describe three patients who met the diagnostic criteria for DM and developed tuberculous myositis. The first case, a 54-year-old woman, had a positive polymerase chain reaction (PCR) for Mycobacterium tuberculosis detected in a post-mortem muscle biopsy. A second patient was diagnosed with a positive Ziehl-Neelsen stain in bronchoalveolar lavage, and a third patient, with multiple collections in the thorax and lower limbs, had positive Ziehl-Neelsen stain and PCR for Mycobacterium tuberculosis. In inflammatory myopathies, muscle and soft tissue infection by tuberculosis may produce symptoms similar to the underlying disease. The differential diagnosis of tuberculosis superinfection can be difficult.
Rosa J, Garrot LF, Navarta DA, Saucedo C, Scolnik M, Bedran Z, et al. Incidence and prevalence of polymyositis and dermatomyositis in a health management organization in Buenos Aires. J Clin Rheumatol 2013; 19: 303-7.
DOI: https://doi.org/10.1097/RHU.0b013e3182a21ba8
Schiopu E, Phillips K, MacDonald PM, Crofford LJ, Somers EC. Predictors of survival in a cohort of patients with polymyositis and dermatomyositis: effect of corticosteroids, methotrexate and azathioprine. Arthritis Res Ther 2012; 14: R22.
DOI: https://doi.org/10.1186/ar3704
Argentine Ministry of Health. Bulletin No. 5. Tuberculosis and leprosy in Argentina. 2022.
Chen IJ, Tsai WP, Jan Wu YJ, Luo SF, Ho HH, Liou LB, et al. Infections in polymyositis and dermatomyositis: analysis of 192 cases. Rheumatology 2010; 49: 2429-37.
DOI: https://doi.org/10.1093/rheumatology/keq279
Haldule S, Chatterjee M, Goswami RP, Vadsaria I, Gaur P, Kavadichanda C, et al. A systematic review and meta-analysis of mycobacterial infections in patients with idiopathic inflammatory myopathies. Rheumatology 2022; 61: 3521-33.
DOI: https://doi.org/10.1093/rheumatology/keac041
Wu PH, Lin YT, Yang YH, Lin YC, Lin YC. The increased risk of active tuberculosis disease in patients with dermatomyositis - a nationwide retrospective cohort study. Sci Rep 2015; 5: 16303.
DOI: https://doi.org/10.1038/srep16303
Gupta L, Aggarwal R, Naveen R, Lawrence A, Zanwar A, Misra DP, et al. High prevalence of active tuberculosis in adults and children with idiopathic inflammatory myositis as compared with systemic lupus erythematosus in a tuberculosis endemic country: retrospective data review from a tertiary care centre in India. Mediterr J Rheumatol 2020; 32: 132-42.
DOI: https://doi.org/10.31138/mjr.32.2.134
Abreu AS, Fernandes GH, Borba EF, Guedes LKN, Ramos JF, Shinjo SK. Musculoskeletal tuberculosis in dermatomyositis: association or coincidence? Open J Rheumatol Autoimmune Dis 2014; 04: 58-61.
DOI: https://doi.org/10.4236/ojra.2014.41009
Liu CH, Liu WC, Chen LW, Chen JS. Tuberculous myofasciitis in dermatomyositis. Clin Rheumatol 2008; 27: S7-9.
DOI: https://doi.org/10.1007/s10067-007-0799-3
Simopoulou T, Varna A, Dailiana Z, Katsiari C, Alexiou I, Basdekis G, et al. Tuberculous pyomyositis: a re-emerging entity of many faces. Clin Rheumatol 2016; 35: 1105-10.
DOI: https://doi.org/10.1007/s10067-014-2564-8
Rajalingham S, Mohd Said MS, Shaharir SS, Abaziz A, Periyasamy P, Anshar FM. Dermatomyositis masquerading musculoskeletal tuberculosis. BMJ Case Rep 2011; 2011: bcr0820114675.
DOI: https://doi.org/10.1136/bcr.08.2011.4675
Gao W, Zeng Y, Chen W. Multiple subcutaneous tuberculous abscesses in a dermatomyositis patient without pulmonary tuberculosis: a case report and literature review. BMC Infect Dis 2020; 20: 409.
DOI: https://doi.org/10.1186/s12879-020-05137-w
Purohit M, Mustafa T. Laboratory diagnosis of extra-pulmonary tuberculosis (EPTB) in Resource-constrained Setting: State of the Art, Challenges and the Need. J Clin Diagn Res 2015; 9: EE01-6.
DOI: https://doi.org/10.7860/JCDR/2015/12422.5792
Anton C, Machado FD, Ahumada Ramirez JM, Manzoni Bernardi R, Palominos PE, Viegas Brenol C, et al. Latent infection in patients with rheumatic diseases. J Bras Pneumol 2019; 45: e20190023.
DOI: https://doi.org/10.1590/1806-3713/e20190023
How to Cite
Palomino Romero, L. C., Vargas Caselles, A., Rius, N. S., Soriano, E., Rosa, J., & Scolnik, M. (2025). Tuberculosis infection in patients with dermatomyositis. Reumatismo. https://doi.org/10.4081/reumatismo.2025.1631
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