RT Journal Article SR Electronic T1 Systemic Sclerosis and the Risk of Tuberculosis JF The Journal of Rheumatology JO J Rheumatol FD The Journal of Rheumatology SP jrheum.131125 DO 10.3899/jrheum.131125 A1 Shuo-Ming Ou A1 Wen-Chien Fan A1 Kun-Ta Cho A1 Chiu-Mei Yeh A1 Vincent Yi-Fong Su A1 Man-Hsin Hung A1 Yu-Sheng Chang A1 Yi-Jung Lee A1 Yung-Tai Chen A1 Pei-Wen Chao A1 Wu-Chang Yang A1 Tzeng-Ji Chen A1 Wei-Shu Wang A1 Hsuan-Ming Tsao A1 Li-Fu Chen A1 Fa-Yauh Lee A1 Chia-Jen Liu YR 2014 UL http://www.jrheum.org/content/early/2014/07/10/jrheum.131125.abstract AB Objective Pulmonary involvement is common in patients with systemic sclerosis (SSc), and this condition causes substantial morbidity and mortality. Disrupted immunity from the disease or associated medication may render such patients subject to tuberculosis (TB) infection. However, the relationship between SSc and TB has not yet been investigated. Methods Using the Taiwan National Health Insurance Research Database, 838 patients with SSc diagnosed in Taiwan during 2000–2006 were identified and followed for emergence of TB infection. Incidence rate ratios (IRR) of TB compared to 8380 randomly selected age-, sex-, and comorbidity-matched controls without SSc were calculated. The Cox proportional hazards model was used for multivariate adjustment to identify independent risk factors for TB infection. Results The risk of TB infection was higher in the SSc cohort than in controls (IRR 2.81, 95% CI 1.36–5.37; p = 0.004), particularly for pulmonary TB (IRR 2.53, 95% CI 1.08–5.30; p = 0.022). Other independent risk factors for TB infection in patients with SSc were age ≥ 60 years [hazard ratio (HR) 3.52, 95% CI 1.10–11.33; p = 0.035] and pulmonary hypertension (PH; HR 6.06, 95% CI 1.59–23.17; p = 0.008). Mortality did not differ for SSc patients with or without TB. Conclusion In this nationwide study, the incidence of TB infection was significantly higher among patients with SSc than in controls without SSc. Special care should be taken in managing patients with SSc who are at high risk for TB, especially those aged ≥ 60 years or who also have PH.