EXTRAPULMONARY TUBERCULOSIS IN A KAZAKH PATIENT WITH MIXED CONNECTIVE TISSUE DISEASE. СLINICAL CASE

Abstract

Patients with systemic autoimmune diseases have increased susceptibility to infections, including tuberculosis, partly due to immunosuppressive treatment. We describe a case of extrapulmonary tuberculosis (tuberculous osteomyelitis of the right foot) occurring a few months after a diagnosis and apparently successful treatment of abdominal TB in a Kazakh patient with mixed connective tissue disease. Abdominal tuberculosis had occurred while the patient was on high doses of corticosteroids, whereas bone tuberculosis was diagnosed when glucocorticoid doses had been reduced. The diagnosis of tuberculous osteomyelitis was unfortunately made months after the disease manifested. Screening for latent tuberculosis should be mandatory before starting immunosuppressive treatment in patients with autoimmune diseases, especially in countries with a considerable tuberculosis burden, and tuberculosis should be high in the list of possible etiologies of multiple clinical manifestations in these patients.