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Associations between selected immune-mediated diseases and tuberculosis: record-linkage studies

BACKGROUND: Previous studies have suggested that there may be an association between some immune-mediated diseases and risk of tuberculosis (TB). METHODS: We analyzed a database of linked statistical records of hospital admissions and death certificates for the whole of England (1999 to 2011), and a...

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Autores principales: Ramagopalan, Sreeram V, Goldacre, Raph, Skingsley, Andrew, Conlon, Chris, Goldacre, Michael J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616814/
https://www.ncbi.nlm.nih.gov/pubmed/23557090
http://dx.doi.org/10.1186/1741-7015-11-97
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author Ramagopalan, Sreeram V
Goldacre, Raph
Skingsley, Andrew
Conlon, Chris
Goldacre, Michael J
author_facet Ramagopalan, Sreeram V
Goldacre, Raph
Skingsley, Andrew
Conlon, Chris
Goldacre, Michael J
author_sort Ramagopalan, Sreeram V
collection PubMed
description BACKGROUND: Previous studies have suggested that there may be an association between some immune-mediated diseases and risk of tuberculosis (TB). METHODS: We analyzed a database of linked statistical records of hospital admissions and death certificates for the whole of England (1999 to 2011), and a similar database (the Oxford Record Linkage Study (ORLS)) for a region of southern England in an earlier period. Rate ratios for TB were determined, comparing immune-mediated disease cohorts with comparison cohorts. RESULTS: In the all-England dataset, there were significantly elevated risks of TB after hospital admission for the following individual immune-mediated diseases: Addison's disease, ankylosing spondylitis, autoimmune hemolytic anemia, chronic active hepatitis, coeliac disease, Crohn's disease, dermatomyositis, Goodpasture's syndrome, Hashimoto's thyroiditis, idiopathic thrombocytopenia purpura (ITP), myasthenia gravis, myxedema, pemphigoid, pernicious anemia, polyarteritis nodosa, polymyositis, primary biliary cirrhosis, psoriasis, rheumatoid arthritis, scleroderma, Sjögren's syndrome, systemic lupus erythematosus (SLE), thyrotoxicosis and ulcerative colitis. Particularly high levels of risk were found for Addison’s disease (rate ratio (RR) = 11.9 (95% CI 9.5 to 14.7)), Goodpasture’s syndrome (RR = 10.8 (95% CI 4.0 to 23.5)), SLE (RR = 9.4 (95% CI 7.9 to 11.1)), polymyositis (RR = 8.0 (95% CI 4.9 to 12.2)), polyarteritis nodosa (RR = 6.7 (95% CI 3.2 to 12.4)), dermatomyositis (RR = 6.6 (95% CI 3.0 to 12.5)), scleroderma (RR = 6.1 (95% CI 4.4 to 8.2)) and autoimmune hemolytic anemia (RR = 5.1 (95% CI 3.4 to 7.4)). CONCLUSIONS: These two databases show that patients with some immune-mediated diseases have an increased risk of TB, although we cannot explicitly state the direction of risk or exclude confounding. Further study of these associations is warranted, and these findings may aid TB screening, control and treatment policies.
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spelling pubmed-36168142013-04-05 Associations between selected immune-mediated diseases and tuberculosis: record-linkage studies Ramagopalan, Sreeram V Goldacre, Raph Skingsley, Andrew Conlon, Chris Goldacre, Michael J BMC Med Research Article BACKGROUND: Previous studies have suggested that there may be an association between some immune-mediated diseases and risk of tuberculosis (TB). METHODS: We analyzed a database of linked statistical records of hospital admissions and death certificates for the whole of England (1999 to 2011), and a similar database (the Oxford Record Linkage Study (ORLS)) for a region of southern England in an earlier period. Rate ratios for TB were determined, comparing immune-mediated disease cohorts with comparison cohorts. RESULTS: In the all-England dataset, there were significantly elevated risks of TB after hospital admission for the following individual immune-mediated diseases: Addison's disease, ankylosing spondylitis, autoimmune hemolytic anemia, chronic active hepatitis, coeliac disease, Crohn's disease, dermatomyositis, Goodpasture's syndrome, Hashimoto's thyroiditis, idiopathic thrombocytopenia purpura (ITP), myasthenia gravis, myxedema, pemphigoid, pernicious anemia, polyarteritis nodosa, polymyositis, primary biliary cirrhosis, psoriasis, rheumatoid arthritis, scleroderma, Sjögren's syndrome, systemic lupus erythematosus (SLE), thyrotoxicosis and ulcerative colitis. Particularly high levels of risk were found for Addison’s disease (rate ratio (RR) = 11.9 (95% CI 9.5 to 14.7)), Goodpasture’s syndrome (RR = 10.8 (95% CI 4.0 to 23.5)), SLE (RR = 9.4 (95% CI 7.9 to 11.1)), polymyositis (RR = 8.0 (95% CI 4.9 to 12.2)), polyarteritis nodosa (RR = 6.7 (95% CI 3.2 to 12.4)), dermatomyositis (RR = 6.6 (95% CI 3.0 to 12.5)), scleroderma (RR = 6.1 (95% CI 4.4 to 8.2)) and autoimmune hemolytic anemia (RR = 5.1 (95% CI 3.4 to 7.4)). CONCLUSIONS: These two databases show that patients with some immune-mediated diseases have an increased risk of TB, although we cannot explicitly state the direction of risk or exclude confounding. Further study of these associations is warranted, and these findings may aid TB screening, control and treatment policies. BioMed Central 2013-04-04 /pmc/articles/PMC3616814/ /pubmed/23557090 http://dx.doi.org/10.1186/1741-7015-11-97 Text en Copyright © 2013 Ramagopalan et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Ramagopalan, Sreeram V
Goldacre, Raph
Skingsley, Andrew
Conlon, Chris
Goldacre, Michael J
Associations between selected immune-mediated diseases and tuberculosis: record-linkage studies
title Associations between selected immune-mediated diseases and tuberculosis: record-linkage studies
title_full Associations between selected immune-mediated diseases and tuberculosis: record-linkage studies
title_fullStr Associations between selected immune-mediated diseases and tuberculosis: record-linkage studies
title_full_unstemmed Associations between selected immune-mediated diseases and tuberculosis: record-linkage studies
title_short Associations between selected immune-mediated diseases and tuberculosis: record-linkage studies
title_sort associations between selected immune-mediated diseases and tuberculosis: record-linkage studies
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616814/
https://www.ncbi.nlm.nih.gov/pubmed/23557090
http://dx.doi.org/10.1186/1741-7015-11-97
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