Treatment of latent tuberculosis in a child with mucopolysaccharidosis type I receiving enzyme replacement therapy: A case report

Front Pediatr. 2022 Aug 16;10:973193. doi: 10.3389/fped.2022.973193.

PMID: 36052356

Lauma Vasilevska, Madara Auzenbaha, Ieva Grinfelde

Highlights: This case report demonstrates that tuberculosis and mucopolysaccharidosis type I S can be treated simultaneously without serious adverse effects.

Abstract

Background: A rare autosomal recessive lysosomal storage disorder called mucopolysaccharidosis type I S (MPS IS) is brought on by mutations in the IDUA gene that prevent the production of the enzyme alpha-L-iduronidase. Enzyme replacement treatment (ERT) lessens liver lysosomal storage and improves clinical symptoms. Since there have been no documented cases of tuberculosis (TB) treatment in MPS IS patients getting ERT, it is unknown whether both disorders may be managed concurrently.

Results: This article describes the case of a 14-year-old boy with MPS IS who was undergoing ERT with laronidase when he was discovered to have latent tuberculosis after coming into touch with a patient who was multi-drug resistant. He underwent a 6-month course of moxifloxacin prophylaxis for tuberculosis. No complications were reported and there has been no active TB disease.

Conclusion: This case study reveals that treating TB and MPS IS concurrently is possible without experiencing any negative side effects.

Keywords: MPS, enzyme replacement therapy (ERT), laronidase, latent tuberculosis treatment, mucopolysaccharidosis type I, multi drug resistant tuberculosis (MDR-TB)