AUTOANTIBODY PROFILES IN PATIENTS WITH ACTIVE LUNG TUBERCULOSIS

Background: Tuberculosis (TB) infection, which involves a chronic stimulation of the immune system, may share similarities with connective tissue diseases, such as fever, myalgia, pulmonary and musculoskeletal involvementObjectives: To determine the prevalence of a wide array of autoantibodies in the sera of patients with tuberculosis (TB) compared with healthy controls.Methods: Consecutive patients with recently diagnosed active pulmonary TB (N=47, age 47±21, 29 males/21 females) and 39 healthy controls participated in this study. Data were collected on a questionnaire including clinical features of the disease, duration of symptoms, fever, cough, arthralgia, myalgia, sicca symptoms and others. Sera of the patients were collected before starting treatment for TB and frozen at -20°C. Anti-CCP and IgM-RF were evaluated by ELISA.Results: The mean duration of TB related symptoms was 4.4±1.7 months, 73% had fever, 94% presented with cough. Rheumatic symptoms were relatively rare: arthralgia (4%), myalgias (4%), eye and mouth dryness (2 and 8%, respectively). The mean serum levels of anti-dsDNA, anti Sm, anti-RNP, anti-SSA, anti-ACA-IgG and IgM were significantly increased in TB patients in comparison with healthy controls. A significantly higher proportion of TB patients increased pathological levels of anti-dsDNA (32 vs 2.5%), anti Sm (38 vs. 0%), anti-RNP (15 vs. 0%), anti-SSA (64 vs. 10%), anti-ACA-IgG (59 vs 0%) and anti-ACA-IgM (47 vs 7.7%).Conclusion: A significant proportion of patients with active TB present increased titer of a variety of autoantibodies, including serological markers considered highly specific such as anti-Sm. These findings should be considered in the interpretation of serological studies in patients with systemic manifestations.Citation: Ann Rheum Dis, volume 65, supplement II, year 2006, page 549Session: Infection-related rheumatic diseases