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...
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MDPI AG
2024-09-01
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| 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 |