Tuberculosis-Induced Immune-Mediated Necrotizing Myopathy: A Challenging Case Scenario in a Non-Endemic Country

<b>Background and Clinical Significance</b>: Tuberculosis (TB) poses a significant global health challenge; although low–middle income countries carry the heaviest burden, its diagnosis and treatment can be challenging in any country. The clinical picture can be complex and vary from per...

Full description

Saved in:
Bibliographic Details
Main Authors: Agnese Colpani, Davide Astorri, Andrea De Vito, Giordano Madeddu, Sandro Panese, Nicholas Geremia
Format: Article
Language:English
Published: MDPI AG 2024-09-01
Series:Reports
Subjects:
Online Access:https://www.mdpi.com/2571-841X/7/4/82
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850037454180974592
author Agnese Colpani
Davide Astorri
Andrea De Vito
Giordano Madeddu
Sandro Panese
Nicholas Geremia
author_facet Agnese Colpani
Davide Astorri
Andrea De Vito
Giordano Madeddu
Sandro Panese
Nicholas Geremia
author_sort Agnese Colpani
collection DOAJ
description <b>Background and Clinical Significance</b>: Tuberculosis (TB) poses a significant global health challenge; although low–middle income countries carry the heaviest burden, its diagnosis and treatment can be challenging in any country. The clinical picture can be complex and vary from person to person, with autoimmune complications that can hinder TB diagnosis and treatment. <b>Case Presentation</b>: We report the case of a 38-year-old man from Bangladesh who had recently arrived in Italy through the Balkan route. He presented with TB in the cervical lymph nodes and long-standing chronic myalgias. While a wide range of TB-triggered autoimmune entities can be found in the literature, this case is the first to describe immune-mediated necrotizing myopathy (IMNM) triggered by active TB. <b>Conclusions</b>: IMNM has been previously associated only with other infections like SARS-CoV-2 and Dengue. The successful diagnosis and management of TB-induced IMNM was achieved through a collaborative, multidisciplinary approach involving rheumatologists, immunologists, and infectious diseases specialists, showcasing an innovative treatment strategy and adding new insights into the complexities of TB and IMNM.
format Article
id doaj-art-e6ee9f677d3040a293dca696b98a2de0
institution DOAJ
issn 2571-841X
language English
publishDate 2024-09-01
publisher MDPI AG
record_format Article
series Reports
spelling doaj-art-e6ee9f677d3040a293dca696b98a2de02025-08-20T02:56:51ZengMDPI AGReports2571-841X2024-09-01748210.3390/reports7040082Tuberculosis-Induced Immune-Mediated Necrotizing Myopathy: A Challenging Case Scenario in a Non-Endemic CountryAgnese Colpani0Davide Astorri1Andrea De Vito2Giordano Madeddu3Sandro Panese4Nicholas Geremia5Unit of Infectious Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, ItalyRheumatology Unit, Department of Medicine, Ospedale Civile “S.S. Giovanni e Paolo”, 30122 Venice, ItalyUnit of Infectious Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, ItalyUnit of Infectious Diseases, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, ItalyUnit of Infectious Diseases, Department of Clinical Medicine, Ospedale “dell’Angelo”, 30174 Venice, ItalyUnit of Infectious Diseases, Department of Clinical Medicine, Ospedale “dell’Angelo”, 30174 Venice, Italy<b>Background and Clinical Significance</b>: Tuberculosis (TB) poses a significant global health challenge; although low–middle income countries carry the heaviest burden, its diagnosis and treatment can be challenging in any country. The clinical picture can be complex and vary from person to person, with autoimmune complications that can hinder TB diagnosis and treatment. <b>Case Presentation</b>: We report the case of a 38-year-old man from Bangladesh who had recently arrived in Italy through the Balkan route. He presented with TB in the cervical lymph nodes and long-standing chronic myalgias. While a wide range of TB-triggered autoimmune entities can be found in the literature, this case is the first to describe immune-mediated necrotizing myopathy (IMNM) triggered by active TB. <b>Conclusions</b>: IMNM has been previously associated only with other infections like SARS-CoV-2 and Dengue. The successful diagnosis and management of TB-induced IMNM was achieved through a collaborative, multidisciplinary approach involving rheumatologists, immunologists, and infectious diseases specialists, showcasing an innovative treatment strategy and adding new insights into the complexities of TB and IMNM.https://www.mdpi.com/2571-841X/7/4/82tuberculosisimmune-mediated necrotizing myopathyanti-HMGCR myopathy
spellingShingle Agnese Colpani
Davide Astorri
Andrea De Vito
Giordano Madeddu
Sandro Panese
Nicholas Geremia
Tuberculosis-Induced Immune-Mediated Necrotizing Myopathy: A Challenging Case Scenario in a Non-Endemic Country
Reports
tuberculosis
immune-mediated necrotizing myopathy
anti-HMGCR myopathy
title Tuberculosis-Induced Immune-Mediated Necrotizing Myopathy: A Challenging Case Scenario in a Non-Endemic Country
title_full Tuberculosis-Induced Immune-Mediated Necrotizing Myopathy: A Challenging Case Scenario in a Non-Endemic Country
title_fullStr Tuberculosis-Induced Immune-Mediated Necrotizing Myopathy: A Challenging Case Scenario in a Non-Endemic Country
title_full_unstemmed Tuberculosis-Induced Immune-Mediated Necrotizing Myopathy: A Challenging Case Scenario in a Non-Endemic Country
title_short Tuberculosis-Induced Immune-Mediated Necrotizing Myopathy: A Challenging Case Scenario in a Non-Endemic Country
title_sort tuberculosis induced immune mediated necrotizing myopathy a challenging case scenario in a non endemic country
topic tuberculosis
immune-mediated necrotizing myopathy
anti-HMGCR myopathy
url https://www.mdpi.com/2571-841X/7/4/82
work_keys_str_mv AT agnesecolpani tuberculosisinducedimmunemediatednecrotizingmyopathyachallengingcasescenarioinanonendemiccountry
AT davideastorri tuberculosisinducedimmunemediatednecrotizingmyopathyachallengingcasescenarioinanonendemiccountry
AT andreadevito tuberculosisinducedimmunemediatednecrotizingmyopathyachallengingcasescenarioinanonendemiccountry
AT giordanomadeddu tuberculosisinducedimmunemediatednecrotizingmyopathyachallengingcasescenarioinanonendemiccountry
AT sandropanese tuberculosisinducedimmunemediatednecrotizingmyopathyachallengingcasescenarioinanonendemiccountry
AT nicholasgeremia tuberculosisinducedimmunemediatednecrotizingmyopathyachallengingcasescenarioinanonendemiccountry