Diagnosis and treatment of latent tuberculosis in patients with multiple sclerosis, expert consensus. On behalf of the Colombian Association of Neurology, Committee of Multiple Sclerosis

Carlos Navas, Carlos A. Torres-Duque, Joe Munoz-Ceron, Carlos Álvarez, Juan R. García, Luis Zarco, Lázaro A. Vélez, Carlos Awad, Carlos Alberto Castro

Producción científica: Contribución a una revistaArtículorevisión exhaustiva

12 Citas (Scopus)

Resumen

Background
Multiple sclerosis is an inflammatory and neurodegenerative demyelinating disease. Current treatment of multiple sclerosis focuses on the use of immunomodulatory, immunosuppressant, and selective immunosuppressant agents. Some of these medications may result in high risk of opportunistic infections including tuberculosis.

Objective
The purpose of this study was to obtain consensus from a panel of neurologists, pulmonologists, infectious disease specialists, and epidemiology experts regarding the diagnosis, treatment, and monitoring of latent tuberculosis in patients with multiple sclerosis.

Methods
A panel of experts in multiple sclerosis and tuberculosis was established. The methodological process was performed in three phases: definition of questions, answer using Delphi methodology, and the discussion of questions not agreed.

Results
Tuberculosis screening is suggested when multiple sclerosis drugs are prescribed. The recommended tests for latent tuberculosis are tuberculin and interferon gamma release test. When an anti-tuberculosis treatment is indicated, monitoring should be performed to determine liver enzyme values with consideration of age as well as comorbid conditions such as a history of alcoholism, age, obesity, concomitant hepatotoxic drugs, and history of liver disease.

Conclusion
Latent tuberculosis should be considered in patients with multiple sclerosis who are going to be treated with immunomodulatory and immunosuppressant medications. Transaminase level monitoring is required on a periodic basis depending on clinical and laboratory characteristics. In addition to the liver impairment, other side effects should be considered when Isoniazid is prescribed.
Idioma originalInglés estadounidense
PublicaciónMultiple Sclerosis Journal - Experimental, Translational and Clinical
Volumen4
N.º1
DOI
EstadoPublicada - ene. 1 2018
Publicado de forma externa

Áreas temáticas de ASJC Scopus

  • Neurología clínica
  • Neurociencia celular y molecular

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