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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(07): s00451810406
DOI: 10.1055/s-0045-1810406
Review Article

Active tuberculosis and multiple sclerosis: the importance of screening before treatment

Leizian de Souza Amorim 
1   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
,
Paloma Peter Travassos Zaidan 
1   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
,
Felipe Toscano Lins de Menezes 
1   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
,
Enedina Maria Lobato de Oliveira 
1   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
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Abstract

Tuberculosis (TB), a chronic infection caused by the Mycobacterium tuberculosis complex, has an increased risk of reactivation in conditions that affect the immune system, such as MS, and its treatment with disease-modifying drugs (DMDs). The present is a retrospective study of 2,036 patients diagnosed with MS followed at the Department of Neurology and Neurosurgery of Escola Paulista de Medicina, Universidade Federal de São Paulo, from February 1994 to September 2023. Of that total, 6 were included in this case series, taking different DMDs: fingolimod (n = 2), interferon beta 1a (n = 2), glatiramer acetate (n = 1) and cyclophosphamide (n = 1). In our study, two patients experienced worsening disability during tuberculosis treatment, while three others had increased disability after completing treatment. We reinforce the importance of screening all patients eligible for DMD treatment, especially the highly effective modern ones, and the importance of developing research-based guidelines for screening infectious diseases among patients with MS.

Keywords

Multiple Sclerosis - Tuberculosis - Risk Assessment

Authors' Contributions

Conceptualization: LSA, PPTZ; Data curation: LSA, PPTZ, FTLM; Formal analysis: LSA, PPTZ; Funding acquisition: LSA, PPTZ; Investigation: LSA, PPTZ; Methodology: LSA, PPTZ; Supervision: EMLO; Writing – review & editing: LSA, PPTZ.


Data Availability Statement

The evaluation data is made available, but the identity of the participants must be preserved.


Editor-in-Chief: Ayrton Roberto Massaro (https://orcid.org/0000-0002-0487-5299).


Associate Editor: Maria Fernanda Mendes (https://orcid.org/0000-0003-3983-6019).




Publication History

Received: 12 December 2024

Accepted: 04 May 2025

Article published online:
04 August 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
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Bibliographical Record
Leizian de Souza Amorim, Paloma Peter Travassos Zaidan, Felipe Toscano Lins de Menezes, Enedina Maria Lobato de Oliveira. Active tuberculosis and multiple sclerosis: the importance of screening before treatment. Arq Neuropsiquiatr 2025; 83: s00451810406.
DOI: 10.1055/s-0045-1810406
 

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