Erythema nodosum and the risk of tuberculosis in a high incidence setting

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  • Karen Bjorn-Mortensen
  • Karin Ladefoged
  • Jacob Simonsen
  • Sascha W. Michelsen
  • Hans Christian F. Sørensen
  • Anders Koch
  • Lillebæk, Troels
  • Aase Bengaard Andersen
  • Bolette Soborg

Objective. This study estimates the erythema nodosum (EN) incidence in a tuberculosis (TB) endemic setting and evaluates the likelihood of a subsequent TB diagnosis among individuals with Mycobacterium tuberculosis infection (MTI) with or without EN. Design. We estimated EN incidence rates (IRs) in East Greenland in 2010-2011 and conducted a cohort study following all individuals who tested positive for MTI from 1 January 2010 until 31 December 2012. A personal identifier allowed individual follow-up in the mandatory TB register. MTI was defined by a positive interferongamma release assay. TB incidence rate ratios (IRRs) among participants with or without EN were estimated with the Cox proportional hazard model. Results. We identified 38 EN cases corresponding to an IR of 500/100,000 inhabitants/year. All cases were among individuals with MTI. The EN IR was 11.79 (95% CI 5.73-24.27) times higher for BCG-unvaccinated compared with BCG-vaccinated individuals. The TB IRR was 25 (95% CI 11-60) within 1 month of EN compared to individuals without EN. Conclusion. This study documents a high ENincidence in a TB endemic region. EN occurred only in individuals with MTI, and predominantly among BCG-unvaccinated individuals. EN was significantly associated with a TB diagnosis within 1 month of diagnosis.

Original languageEnglish
Article number32666
JournalInternational Journal of Circumpolar Health
Volume75
ISSN1239-9736
DOIs
Publication statusPublished - 2016

    Research areas

  • Erythema Nodosum, Greenland, Interferon gamma release assay, Mycobacterium tuberculosis, Tuberculosis

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