바로가기메뉴

본문 바로가기 주메뉴 바로가기

A Case of Miliary Tuberculosis in a Patient with Behcet’s Disease and Uveitis Receiving Infliximab

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2009, v.67 no.5, pp.454-457







  • Downloaded
  • Viewed

Abstract

Infliximab, a TNF-α antagonist, has been used to treat refractory rheumatoid arthritis, ankylosing spondylitis,Crohn’s disease and Behcet’s disease. Tuberculosis (TB) is a well-known opportunistic infection in patients receiving infliximab. Therefore, patients should be screened and treated for latent or active TB infection before being administered infliximab. Recently, we encountered a case of military TB during infliximab therapy in a patient suffering from Behcet’s disease and uveitis. We report this case with a review of the relevant literature.

keywords
Tumor Necrosis Factor-alpha, Infliximab, Tuberculosis, Miliary

Reference

1.

Turan B, Gallati H, Erdi H, Gurler A, Michel BA, Villiger PM. Systemic levels of the T cell regulatory cytokines IL-10 and IL-12 in Bechcet's disease; soluble TNFR-75 as a biological marker of disease activity. J Rheumatol 1997;24:128-32.

2.

Niccoli L, Nannini C, Benucci M, Chindamo D, Cassara E, Salvarani C, et al. Long-term efficacy of infliximab in refractory posterior uveitis of Behcet's disease: a 24-month follow-up study. Rheumatology (Oxford) 2007;46:1161-4.

3.

Seong SS, Choi CB, Woo JH, Bae KW, Joung CL, Uhm WS, et al. Incidence of tuberculosis in Korean patients with rheumatoid arthritis (RA): effects of RA itself and of tumor necrosis factor blockers. J Rheumatol 2007;34:706-11.

4.

Accorinti M, Pirraglia MP, Paroli MP, Priori R, Conti F, Pivetti-Pezzi P. Infliximab treatment for ocular and extraocular manifestations of Behcet's disease. Jpn J Ophthalmol 2007;51:191-6.

5.

Wallis RS, Broder MS, Wong JY, Hanson ME, Beenhouwer DO. Granulomatous infectious diseases associated with tumor necrosis factor antagonists. Clin Infect Dis 2004;38:1261-5.

6.

Balcewicz-Sablinska MK, Keane J, Kornfeld H, Remold HG. Pathogenic Mycobacterium tuberculosis evades apoptosis of host macrophages by release of TNF-R2, resulting in inactivation of TNF-alpha. J Immunol 1998;161:2636-41.

7.

Wagner TE, Huseby ES, Huseby JS. Exacerbation of Mycobacterium tuberculosis enteritis masquerading as Crohn's disease after treatment with a tumor necrosis factor-alpha inhibitor. Am J Med 2002;112:67-9.

8.

Wolfe F, Michaud K, Anderson J, Urbansky K. Tuberculosis infection in patients with rheumatoid arthritis and the effect of infliximab therapy. Arthritis Rheum 2004;50:372-9.

9.

Lee YS, Jung JO, Hong JH, Seo YI, Eom KS, Jang SH, et al. Occurrence of tuberculous pleurisy associated with infliximab therapy. Korean J Med 2004;67:421-4.

10.

Kim YH, Lee BJ, Park JJ, Lee WW, Han WS, Oh SN, et al. Tuberculous meningitis in a patient with Crohn's disease, which was treated with infliximab. Korean J Gastrointest Endosc 2007;34:339-42.

11.

British Thoracic Society Standards of Care Committee. BTS recommendations for assessing risk and for managing Mycobacterium tuberculosis infection and disease in patients due to start anti-TNF-alpha treatment. Thorax 2005;60:800-5.

12.

Sichletidis L, Settas L, Spyratos D, Chloros D, Patakas D. Tuberculosis in patients receiving anti-TNF agents despite chemoprophylaxis. Int J Tuberc Lung Dis 2006;10:1127-32.

13.

Ruderman EM, Markenson J. Granulomatous infections and tumor necrosis factor antagonist therapies: update through. Arthritis Rheum 2002;48:S241.

14.

Miyasaka N, Takeuchi T, Eguchi K. Proposed Japanese guidelines for the use of infliximab for rheumatoid arthritis. Mod Rheumatol 2006;15:4-8.

15.

Wallis RS, van Vuuren C, Potgieter S. Adalimumab treatment of life-threatening tuberculosis. Clin Infect Dis 2009;48:1429-32.

Tuberculosis & Respiratory Diseases