Early screening to identify and diagnose primary nasal tuberculosis in patients with tumor necrosis factor inhibitors  

作　　者：Dan-Xiang Shen Yu-Wei Wang Zhi-Min Lin Di Jin Zhen-Hua Ying Chen Li 

机构地区：[1]Department of Internal Medicine,Changxing Third People's Hospital,Huzhou 313000,Zhejiang Province,China [2]Department of Rheumatology and Immunology,Jinzhou Medical University Graduate Training Base Zhejiang Provincial People's Hospital,Center for General Practice Medicine,Zhejiang Provincial People's Hospital,Hangzhou 310000,Zhejiang Province,China [3]Department of Rheumatology,Zhejiang Provincial Key Laboratory of Traditional Chinese Medicine Cultivation for Arthritis Diagnosis and Treatment,Hangzhou 310000,Zhejiang Province,China [4]Department of Cardiology,Yidu Central Hospital of Weifang,Weifang 261000,Shandong Province,China [5]Third Affiliated Hospital,Beijing University of Chinese Medicine,Beijing 100020,China [6]Department of Rheumatology,Weifang People's Hospital,Weifang 261000,Shandong Province,China [7]Department of Rheumatology,Fangshan Hospital,Beijing University of Chinese Medicine,Beijing 102400,China

出　　处：《World Journal of Clinical Cases》2024年第33期6604-6607,共4页世界临床病例杂志（英文）

摘　　要：In this editorial,we comment on the article by Liu et al.Based on our analysis of a case report,we consider that early screening and recognition of primary nasal tuberculosis are crucial for patients undergoing treatment with tumor necrosis factor inhibitor(TNFi).While TNFi therapy increases the risk of reactivating latent tuberculosis,primary nasal tuberculosis remains rare due to the protective mechanisms of the nasal mucosa.Risk factors for primary nasal tuberculosis include minimally invasive nasal surgery,diabetes,and human immunodefi ciency virus.Patients with early symptoms such as nasal congestion,rhinorrhea,altered olfaction,epistaxis,or ulceration,and unresponsive to conventional antibiotics and antihistamines should undergo early rhinoscopy,possibly followed by repeated tissue biopsies and acid-fast bacilli culture when necessary.When diagnosis is challenging,it is essential to consider local tuberculosis epidemiology and the efficacy of diagnostic antituberculosis treatment.The preferred method for tuberculosis screening is the Interferon Gamma Release Assay,with a general recommendation for screening at 3 and 6 months after initial treatment and then every six months.However,the optimal frequency is not yet consensus-driven and may be increased in economically viable settings.

关 键 词：Tumor necrosis factor inhibitor Interferon-gamma release assay Primary nasal tuberculosis Rhinoscopy Diabetes mellitus 

分 类 号：R524[医药卫生—内科学]