Associação entre lúpus eritematoso sistémico e tuberculose – Revisão crítica*

 

João Cláudio Barroso Pereira¹

 

Resumo

Uma análise crítica sobre a associação lúpus eritematoso sistémico e tuberculose é proposta. É feita uma breve revisão sobre lúpus e sobre prováveis factores que desencadeiam a tuberculose nestes doentes, incluindo tópico sobre proteínas de choque térmico da família HSP 70KDa e HSP65KDa do Mycobacterium tuberculosis e receptores Toll TLR2, TLR4 e TLR9 que podem estar envolvidos na interacção entre antigénio do bacilo e tecido do hospedeiro causando indução autoimune no lúpus. Uma revisão de séries clínicas sobre o assunto é mostrada e ressalta as formas extrapulmonares como as mais comuns nestes casos. O autor conclui que diagnóstico precoce e tratamento apropriado são mandatórios em situações nas quais o LES está associado a TB, principalmente em áreas endémicas para esta doença.

Palavras-chave: Associação LES -TB, revisão de séries clínicas, formas extrapulmonares e diagnóstico precoce.

 

 

Systemic lupus erythematosus association with tuberculosis – Critical review

Abstract

The author provides a critical analysis of systemic lupus erythematosus associated with tuberculosis. A brief review of the lupus-tuberculosis association is also given, and stresses that extra-pulmonary TB is the most usual form of TB in these cases. Other issues considered are the heat shock proteins of Mycobacterium tuberculosis HSP70KDa and HSP65KDa families and TLR2, TLR4, TLR9 that can be involved in interaction between bacilli antigen and host tissue causing autoimmune induction by lupus. The author concludes that early diagnosis and appropriate management are mandatory in SLE associated with TB, in areas where TB is endemic.

Key -words: SLE -TB association, clinical series review, extrapulmonary forms, early diagnosis.

 

 

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¹ Médico Tisiologista do Serviço de Atendimento Especializado da SMS-Belford Roxo, Médico do CRA-DIP do Hospital Municipal Nelson de SÁ Earp e do Programa de Controle da Tuberculose da SMS-Petrópolis – Rio de Janeiro, Brasil.

Administradora do Serviço de Atendimento Especializado, Belford Roxo, Rio de Janeiro: Sra. Althair de Araújo Silva

Director do Hospital Municipal Nelson de Sá Earp, Petrópolis, Rio de Janeiro: Dr Roberto Silveira