{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T18:06:48Z","timestamp":1773770808505,"version":"3.50.1"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2013,4,4]],"date-time":"2013-04-04T00:00:00Z","timestamp":1365033600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Previous studies have suggested that there may be an association between some immune-mediated diseases and risk of tuberculosis (TB).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We analyzed a database of linked statistical records of hospital admissions and death certificates for the whole of England (1999 to 2011), and a similar database (the Oxford Record Linkage Study (ORLS)) for a region of southern England in an earlier period. Rate ratios for TB were determined, comparing immune-mediated disease cohorts with comparison cohorts.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>In the all-England dataset, there were significantly elevated risks of TB after hospital admission for the following individual immune-mediated diseases: Addison's disease, ankylosing spondylitis, autoimmune hemolytic anemia, chronic active hepatitis, coeliac disease, Crohn's disease, dermatomyositis, Goodpasture's syndrome, Hashimoto's thyroiditis, idiopathic thrombocytopenia purpura (ITP), myasthenia gravis, myxedema, pemphigoid, pernicious anemia, polyarteritis nodosa, polymyositis, primary biliary cirrhosis, psoriasis, rheumatoid arthritis, scleroderma, Sj\u00f6gren's syndrome, systemic lupus erythematosus (SLE), thyrotoxicosis and ulcerative colitis. Particularly high levels of risk were found for Addison\u2019s disease (rate ratio (RR) = 11.9 (95% CI 9.5 to 14.7)), Goodpasture\u2019s syndrome (RR = 10.8 (95% CI 4.0 to 23.5)), SLE (RR = 9.4 (95% CI 7.9 to 11.1)), polymyositis (RR = 8.0 (95% CI 4.9 to 12.2)), polyarteritis nodosa (RR = 6.7 (95% CI 3.2 to 12.4)), dermatomyositis (RR = 6.6 (95% CI 3.0 to 12.5)), scleroderma (RR = 6.1 (95% CI 4.4 to 8.2)) and autoimmune hemolytic anemia (RR = 5.1 (95% CI 3.4 to 7.4)).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>These two databases show that patients with some immune-mediated diseases have an increased risk of TB, although we cannot explicitly state the direction of risk or exclude confounding. Further study of these associations is warranted, and these findings may aid TB screening, control and treatment policies.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1741-7015-11-97","type":"journal-article","created":{"date-parts":[[2013,4,4]],"date-time":"2013-04-04T08:54:15Z","timestamp":1365065655000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Associations between selected immune-mediated diseases and tuberculosis: record-linkage studies"],"prefix":"10.1186","volume":"11","author":[{"given":"Sreeram V","family":"Ramagopalan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raph","family":"Goldacre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Skingsley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Conlon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J","family":"Goldacre","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2013,4,4]]},"reference":[{"key":"716_CR1","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/S0140-6736(10)62173-3","volume":"378","author":"SD Lawn","year":"2011","unstructured":"Lawn SD, Zumla AI: Tuberculosis. Lancet. 2011, 378: 57-72. 10.1016\/S0140-6736(10)62173-3.","journal-title":"Lancet"},{"key":"716_CR2","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1136\/jech.2010.114595","volume":"66","author":"F Young","year":"2012","unstructured":"Young F, Wotton CJ, Critchley JA, Unwin NC, Goldacre MJ: Increased risk of tuberculosis disease in people with diabetes mellitus: record-linkage study in a UK population. J Epidemiol Community Health. 2012, 66: 519-523. 10.1136\/jech.2010.114595.","journal-title":"J Epidemiol Community Health"},{"key":"716_CR3","doi-asserted-by":"publisher","first-page":"29","DOI":"10.3121\/cmr.2007.754a","volume":"6","author":"MM Patnaik","year":"2008","unstructured":"Patnaik MM, Deshpande AK: Diagnosis-Addison\u2019s disease secondary to tuberculosis of the adrenal glands. Clin Med Res. 2008, 6: 29-10.3121\/cmr.2007.754a.","journal-title":"Clin Med Res"},{"key":"716_CR4","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1136\/thx.2006.059451","volume":"62","author":"JF Ludvigsson","year":"2007","unstructured":"Ludvigsson JF, Wahlstrom J, Grunewald J, Ekbom A, Montgomery SM: Coeliac disease and risk of tuberculosis: a population based cohort study. Thorax. 2007, 62: 23-28. 10.1136\/thx.2006.059451.","journal-title":"Thorax"},{"key":"716_CR5","doi-asserted-by":"publisher","first-page":"1986","DOI":"10.1002\/art.21137","volume":"52","author":"J Askling","year":"2005","unstructured":"Askling J, Fored CM, Brandt L, Baecklund E, Bertilsson L, C\u00f6ster L, Geborek P, Jacobsson LT, Lindblad S, Lysholm J, Rantap\u00e4\u00e4-Dahlqvist S, Saxne T, Romanus V, Klareskog L, Feltelius N: Risk and case characteristics of tuberculosis in rheumatoid arthritis associated with tumor necrosis factor antagonists in Sweden. Arthritis Rheum. 2005, 52: 1986-1992. 10.1002\/art.21137.","journal-title":"Arthritis Rheum"},{"key":"716_CR6","doi-asserted-by":"publisher","first-page":"1669","DOI":"10.1007\/s00296-011-1847-5","volume":"32","author":"Y-C Lin","year":"2012","unstructured":"Lin Y-C, Liang S-J, Liu Y-H, Hsu W-H, Shih C-M, Sung F-C, Chen W: Tuberculosis as a risk factor for systemic lupus erythematosus: results of a nationwide study in Taiwan. Rheumatol Int. 2012, 32: 1669-1673. 10.1007\/s00296-011-1847-5.","journal-title":"Rheumatol Int"},{"key":"716_CR7","doi-asserted-by":"publisher","first-page":"2218","DOI":"10.3899\/jrheum.110373","volume":"38","author":"E-M Kim","year":"2011","unstructured":"Kim E-M, Uhm W-S, Bae S-C, Yoo D-H, Kim T-H: Incidence of tuberculosis among korean patients with ankylosing spondylitis who are taking tumor necrosis factor blockers. J Rheumatol. 2011, 38: 2218-2223. 10.3899\/jrheum.110373.","journal-title":"J Rheumatol"},{"key":"716_CR8","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1007\/BF02724302","volume":"71","author":"S Bakhshi","year":"2004","unstructured":"Bakhshi S, Rao IS, Jain V, Arya LS: Autoimmune hemolytic anemia complicating disseminated childhood tuberculosis. Indian J Pediatr. 2004, 71: 549-551. 10.1007\/BF02724302.","journal-title":"Indian J Pediatr"},{"key":"716_CR9","doi-asserted-by":"publisher","first-page":"802","DOI":"10.7196\/samj.5609","volume":"102","author":"E Deetlefs","year":"2012","unstructured":"Deetlefs E, Epstein D, Watermeyer GA, Seggie RM, Thomson SR: Tuberculosis in an inflammatory bowel disease cohort from South Africa. S Afr Med J. 2012, 102: 802-804.","journal-title":"S Afr Med J"},{"key":"716_CR10","doi-asserted-by":"publisher","first-page":"1404","DOI":"10.1136\/ard.2007.070177","volume":"66","author":"A Airio","year":"2007","unstructured":"Airio A, Kauppi M, Kautiainen H, Hakala M, Kinnula V: High association of mycobacterial infections with polymyositis in a non-endemic country for tuberculosis. Ann Rheum Dis. 2007, 66: 1404-1405. 10.1136\/ard.2007.070177.","journal-title":"Ann Rheum Dis"},{"key":"716_CR11","volume-title":"Int Urol Nephrol","author":"Y-K Wen","year":"2012","unstructured":"Wen Y-K, Wen K-I: Pulmonary hemorrhage complicating Goodpasture\u2019s disease in the course of pulmonary tuberculosis. Int Urol Nephrol. 2012"},{"key":"716_CR12","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1016\/S1413-8670(10)70126-4","volume":"14","author":"P Tabarsi","year":"2010","unstructured":"Tabarsi P, Merza MA, Marjani M: Active pulmonary tuberculosis manifesting with idiopathic thrombocytopenic purpura: a rare presentation. Braz J Infect Dis. 2010, 14: 639-640.","journal-title":"Braz J Infect Dis"},{"key":"716_CR13","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1111\/j.1600-0404.1981.tb00756.x","volume":"63","author":"E Andersen","year":"1981","unstructured":"Andersen E, Isager H, Hyllested K: Risk factors in multiple sclerosis: tuberculin reactivity, age at measles infection, tonsillectomy and appendectomy. Acta Neurol Scand. 1981, 63: 131-135.","journal-title":"Acta Neurol Scand"},{"key":"716_CR14","doi-asserted-by":"publisher","first-page":"79","DOI":"10.5588\/ijtld.12.0260","volume":"17","author":"S-M Ou","year":"2013","unstructured":"Ou S-M, Liu C-J, Chang Y-S, Hu Y-W, Chao P-W, Chen T-J, Tzeng C-H, Wang S-J: Tuberculosis in myasthenia gravis. Int J Tuberc Lung Dis. 2013, 17: 79-84. 10.5588\/ijtld.12.0260.","journal-title":"Int J Tuberc Lung Dis"},{"key":"716_CR15","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/0007-0971(79)90033-0","volume":"73","author":"P Barnes","year":"1979","unstructured":"Barnes P, Weatherstone R: Tuberculosis of the thyroid: two case reports. Br J Dis Chest. 1979, 73: 187-191.","journal-title":"Br J Dis Chest"},{"key":"716_CR16","doi-asserted-by":"publisher","first-page":"280","DOI":"10.2310\/7750.2009.08062","volume":"13","author":"A Goodfellow","year":"2009","unstructured":"Goodfellow A, Keeling DN, Hayes RC, Webster D: Utility of an interferon-gamma release assay for latent tuberculosis diagnosis in a case of bullous pemphigoid. J Cutan Med Surg. 2009, 13: 280-282.","journal-title":"J Cutan Med Surg"},{"key":"716_CR17","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1111\/j.1346-8138.2011.01398.x","volume":"39","author":"H Imanishi","year":"2012","unstructured":"Imanishi H, Tsuruta D, Oshimo T, Sowa J, Mizuno N, Nakagawa K, Ishii M: Cutaneous polyarteritis nodosa induced by Mycobacterium tuberculosis. J Dermatol. 2012, 39: 738-739. 10.1111\/j.1346-8138.2011.01398.x.","journal-title":"J Dermatol"},{"key":"716_CR18","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/1752-1947-2-32","volume":"2","author":"Y Vogel","year":"2008","unstructured":"Vogel Y, Bous JC, Winnekendonk G, Henning BF: Tuberculous peritonitis in a German patient with primary biliary cirrhosis: a case report. J Med Case Rep. 2008, 2: 32-10.1186\/1752-1947-2-32.","journal-title":"J Med Case Rep"},{"key":"716_CR19","first-page":"213","volume":"25","author":"V Bordignon","year":"2011","unstructured":"Bordignon V, Bultrini S, Prignano G, Sperduti I, Piperno G, Bonifati C, Filippetti M, Toma L, Latini A, Di Cecio M, Giuliani A, Vocaturo A, Trento E, D\u2019Agosto G, Francesconi F, Cataldo A, Vento A, Cilenti V, Berardesca E, Ameglio F, Cordiali Fei P, Ensoli F: High prevalence of latent tuberculosis infection in autoimmune disorders such as psoriasis and in chronic respiratory diseases, including lung cancer. J Biol Regul Homeost Agents. 2011, 25: 213-220.","journal-title":"J Biol Regul Homeost Agents"},{"key":"716_CR20","first-page":"2168","volume":"23","author":"J Roddy","year":"1996","unstructured":"Roddy J, Holtby S, Seigel S: Scleroderma concurrent with culture proven tuberculosis in a Japanese Canadian patient. J Rheumatol. 1996, 23: 2168-2170.","journal-title":"J Rheumatol"},{"key":"716_CR21","doi-asserted-by":"publisher","first-page":"1070","DOI":"10.1016\/j.cgh.2007.04.007","volume":"5","author":"FN Aberra","year":"2007","unstructured":"Aberra FN, Stettler N, Brensinger C, Lichtenstein GR, Lewis JD: Risk for active tuberculosis in inflammatory bowel disease patients. Clin Gastroenterol Hepatol. 2007, 5: 1070-1075. 10.1016\/j.cgh.2007.04.007.","journal-title":"Clin Gastroenterol Hepatol"},{"key":"716_CR22","first-page":"1224","volume":"35","author":"RA Asherson","year":"2008","unstructured":"Asherson RA, Gunter K, Daya D, Shoenfeld Y: Multiple autoimmune diseases in a young woman: tuberculosis and splenectomy as possible triggering factors? Another example of the \u201cmosaic\u201d of autoimmunity. J Rheumatol. 2008, 35: 1224-1226.","journal-title":"J Rheumatol"},{"key":"716_CR23","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1007\/s12016-009-8149-7","volume":"38","author":"FM Ribeiro","year":"2010","unstructured":"Ribeiro FM, Szyper-Kravitz M, Klumb EM, Lannes G, Ribeiro FRE, Albuquerque EMM, Shoenfeld Y: Can lupus flares be associated with tuberculosis infection?. Clin Rev Allergy Immunol. 2010, 38: 163-168. 10.1007\/s12016-009-8149-7.","journal-title":"Clin Rev Allergy Immunol"},{"key":"716_CR24","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1136\/jnnp.2009.175463","volume":"81","author":"AF Fois","year":"2010","unstructured":"Fois AF, Wotton CJ, Yeates D, Turner MR, Goldacre MJ: Cancer in patients with motor neuron disease, multiple sclerosis and Parkinson\u2019s disease: record linkage studies. J Neurol Neurosurg Psychiatry. 2010, 81: 215-221. 10.1136\/jnnp.2009.175463.","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"716_CR25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1741-7015-9-1","volume":"9","author":"SV Ramagopalan","year":"2011","unstructured":"Ramagopalan SV, Wotton CJ, Handel AE, Yeates D, Goldacre MJ: Risk of venous thromboembolism in people admitted to hospital with selected immune-mediated diseases: record-linkage study. BMC Med. 2011, 9: 1-10.1186\/1741-7015-9-1.","journal-title":"BMC Med"},{"key":"716_CR26","unstructured":"UK Office of National Statistics: UK indices of multiple deprivation - a way to make comparisons across constituent countries easier. http:\/\/www.ons.gov.uk\/ons\/rel\/hsq\/health-statistics-quarterly\/no--53--spring-2012\/uk-indices-of-multiple-deprivation.html."},{"issue":"82","key":"716_CR27","first-page":"1","volume":"2","author":"NE Breslow","year":"1987","unstructured":"Breslow NE, Day NE: Statistical methods in cancer research. The design and analysis of cohort studies. IARC Sci Publ. 1987, 2 (82): 1-406.","journal-title":"IARC Sci Publ"},{"key":"716_CR28","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1007\/s12016-009-8150-1","volume":"38","author":"Y Shapira","year":"2010","unstructured":"Shapira Y, Agmon-Levin N, Shoenfeld Y: Mycobacterium tuberculosis, autoimmunity, and vitamin D. Clin Rev Allergy Immunol. 2010, 38: 169-177. 10.1007\/s12016-009-8150-1.","journal-title":"Clin Rev Allergy Immunol"}],"container-title":["BMC Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1741-7015-11-97.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1741-7015-11-97\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1741-7015-11-97","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1741-7015-11-97.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T22:57:38Z","timestamp":1630537058000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedicine.biomedcentral.com\/articles\/10.1186\/1741-7015-11-97"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,4,4]]},"references-count":28,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,12]]}},"alternative-id":["716"],"URL":"https:\/\/doi.org\/10.1186\/1741-7015-11-97","relation":{},"ISSN":["1741-7015"],"issn-type":[{"value":"1741-7015","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,4,4]]},"assertion":[{"value":"28 September 2012","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 February 2013","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 April 2013","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"97"}}