TB Research

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

Leizian de Souza Amorim, Paloma Peter Travassos Zaidan, Felipe Toscano Lins de Menezes, Enedina Maria Lobato de Oliveira

Arquivos de Neuro-Psiquiatria · 2025-07

Abstract

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.

MeSH terms

  • Glatiramer acetate
  • Medicine
  • Multiple sclerosis
  • Tuberculosis
  • Fingolimod
  • Natalizumab
  • Internal medicine
  • Neurology
  • Neurosurgery
  • Mycobacterium tuberculosis
  • Dispensary
  • Retrospective cohort study
  • Tb treatment
  • Pediatrics