Given the suspected role of mycobacteria in the establishment
of disorders with an autoimmune background and joint damage, a
study was conducted to analize whether rheumatic symptoms were
likely to be present in tuberculosis (TB) patients. To this
end, 330 patients with a bacteriologic confirmation of
tuberculosis were investigated for the presence of arthritic
complaints. The latter were recorded in five of them with
rheumatic symptoms mostly involving interphalangeal and
metacarpophalangeal joints, and preceding the clinical
manifestations of the TB illness. Three out of these five
patients remained arthritic by the time of the bacteriologic
conversion and fulfilled the criteria for the diagnosis of
rheumatoid arthritis. In the two remaining patients sputum
negativization was accompanied by a disappearance of rheumatic
manifestations. These patients were also assessed for their
peripheral levels of major T cell subsets as well as for the
presence of autoantibodies. Comparisons with a series of
non-arthritic TB cases, rheumatoid arthritis patients, and
controls revealed that presence of rheumatic manifestations
was associated with a different profile of autoantibody
formation and T cell subset changes. Evidence recorded in the
present study indicates that joint affectation in TB is a rare
event, being rather the exception than the rule.
