{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T19:41:03Z","timestamp":1783539663618,"version":"3.55.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2019,12,4]],"date-time":"2019-12-04T00:00:00Z","timestamp":1575417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/501100019178","name":"Sociedad Espa\u00f1ola de Reumatolog\u00eda Pedi\u00e1trica","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100019178","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In adults, anti\u2013tumor necrosis factor-\u03b1 (TNF-\u03b1) therapy is associated with progression of latent tuberculosis (TB) infection (LTBI) to TB disease, but pediatric data are limited.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Retrospective multicenter study within the Paediatric Tuberculosis Network European Trials Group, capturing patients &amp;lt;18 years who developed TB disease during anti\u2013TNF-\u03b1 therapy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Sixty-six tertiary healthcare institutions providing care for children with TB participated. Nineteen cases were identified: Crohn\u2019s disease (n = 8; 42%) and juvenile idiopathic arthritis (n = 6; 32%) were the commonest underlying conditions. Immune-based TB screening (tuberculin skin test and\/or interferon-\u03b3 release assay) was performed in 15 patients before commencing anti\u2013TNF-\u03b1 therapy but only identified 1 LTBI case; 13 patients were already receiving immunosuppressants at the time of screening. The median interval between starting anti\u2013TNF-\u03b1 therapy and TB diagnosis was 13.1 (IQR, 7.1\u201320.3) months. All cases presented with severe disease, predominantly miliary TB (n = 14; 78%). One case was diagnosed postmortem. TB was microbiologically confirmed in 15 cases (79%). The median duration of anti-TB treatment was 50 (IQR, 46\u201366) weeks. Five of 15 (33%) cases who had completed TB treatment had long-term sequelae.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>LTBI screening is frequently false-negative in this patient population, likely due to immunosuppressants impairing test performance. Therefore, patients with immune-mediated diseases should be screened for LTBI at the point of diagnosis, before commencing immunosuppressive medication. Children on anti\u2013TNF-\u03b1 therapy are prone to severe TB disease and significant long-term morbidity. Those observations underscore the need for robust LTBI screening programs in this high-risk patient population, even in low-TB-prevalence settings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz1138","type":"journal-article","created":{"date-parts":[[2019,11,19]],"date-time":"2019-11-19T12:10:53Z","timestamp":1574165453000},"page":"2561-2569","source":"Crossref","is-referenced-by-count":32,"title":["Tuberculosis Disease in Children and Adolescents on Therapy With Antitumor Necrosis Factor-\u0251 Agents: A Collaborative, Multicenter Paediatric Tuberculosis Network European Trials Group (ptbnet) Study"],"prefix":"10.1093","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7485-0583","authenticated-orcid":false,"given":"Antoni","family":"Noguera-Julian","sequence":"first","affiliation":[{"name":"Malalties Infeccioses i Resposta Inflamat\u00f2ria Sist\u00e8mica en Pediatria, Unitat d\u00b4Infeccions, Servei de Pediatria, Institut de Recerca Pedi\u00e0trica Hospital Sant Joan de D\u00e9u, Barcelona, Spain"},{"name":"Departament de Pediatria, Universitat de Barcelona, Barcelona, Spain"},{"name":"CIBER de Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Madrid, Spain"},{"name":"Red de Investigaci\u00f3n Translacional en Infectolog\u00eda Pedi\u00e1trica (RITIP), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Calzada-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Malalties Infeccioses i Resposta Inflamat\u00f2ria Sist\u00e8mica en Pediatria, Unitat d\u00b4Infeccions, Servei de Pediatria, Institut de Recerca Pedi\u00e0trica Hospital Sant Joan de D\u00e9u, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Folke","family":"Brinkmann","sequence":"additional","affiliation":[{"name":"Department of Pulmonology, University Children\u2019s Hospital, Ruhr University, Bochum, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robindra","family":"Basu Roy","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Oxford University, Oxford, United Kingdom"},{"name":"Children\u2019s Hospital, John Radcliffe Hospital, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Bilogortseva","sequence":"additional","affiliation":[{"name":"Department of Child Phthisiology, National Institute of Phthisiology and Pulmonology, National Academy of Medical Sciences of Ukraine, Kiev, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Buettcher","sequence":"additional","affiliation":[{"name":"Lucerne Children\u2019s Hospital, Lucerne Cantonal Hospital, Lucerne, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Vila Nova de Gaia Hospital Centre, Vila Nova de Gaia, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vira","family":"Chechenyeva","sequence":"additional","affiliation":[{"name":"Department of Child Phthisiology, National Institute of Phthisiology and Pulmonology, National Academy of Medical Sciences of Ukraine, Kiev, Ukraine"},{"name":"Center of Infectious Diseases, \u201cClinic for Children With HIV\/AIDS\u201d, National Specialized Children\u2019s Hospital (Okhmatdyt), Kiev, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lola","family":"Falc\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Paediatric Infectious Diseases, Rheumatology and Immunodeficiency, Hospital Virgen del Roc\u00edo, Seville, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Goetzinger","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Adolescent Medicine, Wilhelminenspital, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo","family":"Guerrero-Laleona","sequence":"additional","affiliation":[{"name":"Infectious Diseases Unit, Pediatric Department, Miguel Servet University Hospital\u2013University of Zaragoza, Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Gastroenterology, and Diabetology, Evang. 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