The online version of this article (https://doi.org/10.1186/s12879-017-2930-7) contains supplementary material, which is available to authorized users.
Nontuberculous mycobacterial (NTM) infection in immunocompromized patients is currently a growing health concern, and we aimed to examine the relative risk of NTM infection in patients with Sjögren’s syndrome (SS) compared with that in non-SS individuals.
We used the 2003–2012 Taiwanese National Health Insurance Research Database to identify 6554 incident SS cases during 2007–2012 and selected 98,310 non-SS controls matched (1:15) for age, gender, and the year of first SS diagnosis date after excluding those who had rheumatoid arthritis or systemic lupus erythematosus.
We identified four NTM-infected patients in the SS group (three in the first year) and nine in the non-SS group (three in the first year). SS patients had a higher incidence rate of NTM infection than that in non-SS individuals (IRR, 7.56; 95% CI, 2.33–24.55), especially during the first year (IRR, 16.05; 95% CI, 3.24–79.51). After adjusting for potential confounders, the risk of NTM infection was not increased in SS patients during the entire follow-up period or during the first year, but the risk increased in SS patients treated with immunosuppressants during the entire follow-up period (HR, 17.77; 95% CI, 4.53–69.61), especially during the first year (HR, 33.33; 95% CI, 4.37–254.23).
An increased risk of NTM infection was found in SS patients treated with immunosuppressants during the first year after SS diagnosis.
Additional file 1: Table S1. Unadjusted and adjusted hazard ratios for the association between variable and the risk of NTM infection after the diagnosis. (XLSX 9945 kb)
Additional file 2: Figure S1. Kaplan-Meier survival curve for incidental NTM infection within the 1st year of SS diagnosis. (DOCX 695 kb)
Vivino FB, Carsons SE, Foulks G, Daniels TE, Parke A, Brennan MT, Forstot SL, Scofield RH, Hammitt KM. New treatment guidelines for Sjogren's disease. Rheum Dis Clin N Am. 2016;42(3):531–51. CrossRef
Lim DH, Kim YG, Shim TS, Jo KW, Ghang B, Ahn SM, Hong S, Lee CK, Yoo B. Nontuberculous mycobacterial infection in rheumatoid arthritis patients: a single-center experience in South Korea. Korean J Intern Med. 2017;
The National Health Insurance Statistics 2015. In .: National Health Insurance Administration, Ministry of Health and Welfare, Taiwan, R.O.C.; 2015.
Vitali C, Bombardieri S, Jonsson R, Moutsopoulos HM, Alexander EL, Carsons SE, Daniels TE, Fox PC, Fox RI, Kassan SS, et al. Classification criteria for Sjogren's syndrome: a revised version of the European criteria proposed by the American-European consensus group. Ann Rheum Dis. 2002;61(6):554–8. CrossRefPubMedPubMedCentral
Ummarino D. Connective tissue diseases: Mycobacterial infection and Sjogren syndrome. Nat Rev Rheumatol. 2017;
Chi CY, Lin CH, Ho MW, Ding JY, Huang WC, Shih HP, Yeh CF, Fung CP, Sun HY, Huang CT, et al. Clinical manifestations, course, and outcome of patients with neutralizing anti-interferon-gamma autoantibodies and disseminated nontuberculous mycobacterial infections. Medicine (Baltimore). 2016;95(25):e3927. CrossRef
Gupta S, Tatouli IP, Rosen LB, Hasni S, Alevizos I, Manna ZG, Rivera J, Jiang C, Siegel RM, Holland SM, et al. Distinct functions of autoantibodies against interferon in systemic lupus Erythematosus: a comprehensive analysis of Anticytokine autoantibodies in common rheumatic diseases. Arthritis Rheumatol. 2016;68(7):1677–87. CrossRefPubMedPubMedCentral
Pithukpakorn M, Roothumnong E, Angkasekwinai N, Suktitipat B, Assawamakin A, Luangwedchakarn V, Umrod P, Thongnoppakhun W, Foongladda S, Suputtamongkol Y. HLA-DRB1 and HLA-DQB1 are associated with adult-onset immunodeficiency with acquired anti-interferon-gamma autoantibodies. PLoS One. 2015;10(5):e0128481. CrossRefPubMedPubMedCentral
Brito-Zeron P, Kostov B, Solans R, Fraile G, Suarez-Cuervo C, Casanovas A, Rascon FJ, Qanneta R, Perez-Alvarez R, Ripoll M, et al. Systemic activity and mortality in primary Sjogren syndrome: predicting survival using the EULAR-SS disease activity index (ESSDAI) in 1045 patients. Ann Rheum Dis. 2016;75(2):348–55. CrossRefPubMed
De La Fuente J, Gortazar C, Juste R. Complement component 3: a new paradigm in tuberculosis vaccine. Expert Rev Vaccines. 2016;15(3):275–7. PubMed
Kotilainen H, Lokki ML, Paakkanen R, Seppanen M, Tukiainen P, Meri S, Poussa T, Eskola J, Valtonen V, Jarvinen A. Complement C4 deficiency--a plausible risk factor for non-tuberculous mycobacteria (NTM) infection in apparently immunocompetent patients. PLoS One. 2014;9(3):e91450. CrossRefPubMedPubMedCentral
Cheng TM. Taiwan's new national health insurance program: genesis and experience so far. Health Aff (Millwood). 2003;22(3):61–76. CrossRef
- The risk of nontuberculous mycobacterial infection in patients with Sjögren’s syndrome: a nationwide, population-based cohort study
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II