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| Central Nervous System Tuberculosis After In Vitro Fertilization and Embryo Transfer: a report of 7 Cases and Literature Analysis |
| YU Shan, XU Chunxia, HE Ke, et al |
| Eighth Medical Center of Beijing PLA General Hospital, Beijing 100091, China |
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Abstract Objective: To discuss the clinical characteristics of the central nervous system tuberculosis(CNS-TB) in those women after in vitro fertilization-embryo transfer (IVF-ET), and literature review. Methods: Clinical datas of 7 cases of CNS-TB after IVF-ET from January of 2009 to August of 2018 in the Department of Tuberculosis Research Institute in the Eighth Medical Center of PLA were analyzed retrospectively. Results: 7 cases were diagnosed as CNS-TB after IVF-ET , 4 received IVF-ET once, 2 twice and 1 trice. One failed of transfering, 2 early abortion, 3 mid-term induced abortion and 1 premature fetus died. Among them, 1 case had tuberculous pleurisy in the past and had received full-course anti-tuberculosis treatment, 1 case had tuberculosis of fallopian tube and had not completed treatment due to adverse drug reactions, 2 cases had contact history of tuberculosis patients, and the other 3 cases had no clear history of tuberculosis and contact history. The final diagnoses of 7 cases were as follows, 6 cases with hematogenous pulmonary tuberculosis, 1 case with double pulmonary tuberculosis (sputum positive). Six cases of tuberculous meningoencephalitis had brain tuberculoma, 4 cases combined tuberculous perimyelitis (1 case of endometrial tuberculosis and 1 case of tuberculous polyserositis),and 1 case conbinined pelvic tuberculosis .Four cases had intracranial hypertention and 3 cases had normal intracranial pressure. Interferon-gamma release assays (IGRAs) were positive in 5 cases(one case was not checked), tuberculosis antibodies 38 kD positive in 6 cases, PPD positive in 4 cases and CA125 positive in 6 cases. Conclusion: IVF-ET can significantly increase the incidence of CNS-TB. Once it occurs, the prognosis of pregnancy is poor, which can cause fetal death and maternal dysfunction.
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2019, Vol. 25 
