A case of tuberculous tenosynovitis in a patient with systemic lupus erythematosus

Hand Surgery : an International Journal Devoted to Hand and Upper Limb Surgery and Related Research : Journal of the Asia-Pacific Federation of Societies for Surgery of the Hand
M OshimaY Takakura

Abstract

A 52-year-old woman with systemic lupus erythematosus (SLE) was infected with tuberculosis (TB) on her forearm and hand, after 16 years of steroid therapy. Debridements and anti-TB therapy were performed successfully. Recently, the risk of significant morbidity from TB has been on the rise; this appears to be a complication of steroid therapy used to treat AIDS and some collagen vascular diseases. It is thought that steroid therapy causes an increased risk of TB. In this paper, we report our experience of this SLE patient who developed tuberculous tenosynovitis. We suggest that TB infection must be considered in the differential diagnosis whenever a patient presents with a chronic wrist or hand inflammation that is non-responsive to steroid treatment. Once TB infection is suspected, both histopathological and bacteriological examinations should be performed. Emergent treatment includes surgical debridement and the institution of early anti-TB therapy immediately after completing histopathological examination.

References

Jul 1, 1989·Reviews of Infectious Diseases·R H Jackson, J W King
May 1, 1984·The Journal of Hand Surgery·D C Bush, L H Schneider
Jan 1, 2000·Arthritis and Rheumatism·E M ShanahanO Fitzgerald

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Citations

Jun 2, 2009·Rheumatic Diseases Clinics of North America·Karina D Torralba, Francisco P Quismorio
Nov 22, 2005·Infectious Disease Clinics of North America·Lorne N Small, John J Ross
Mar 22, 2014·World Journal of Orthopedics·Anselm Mak

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