A Patient with Urinary Tract Tuberculosis During Treatment with Etanercept
| Autor: | Shiho Shibata, Eisuke Shono, Emi Nishimagi, Ken Yamaura |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Drug
medicine.medical_specialty Tuberculosis media_common.quotation_subject Urinary system Antitubercular Agents Tuberculosis Urogenital Arthritis Etanercept Arthritis Rheumatoid Internal medicine medicine Humans media_common Tumor Necrosis Factor-alpha business.industry Incidence (epidemiology) Anti-Inflammatory Agents Non-Steroidal Isoniazid Articles General Medicine Middle Aged medicine.disease Surgery Rheumatoid arthritis Female Tomography X-Ray Computed business Follow-Up Studies medicine.drug |
| Zdroj: | The American Journal of Case Reports |
| ISSN: | 1941-5923 |
| Popis: | Patient: Female, 58 Final Diagnosis: — Symptoms: — Medication: — Clinical Procedure: — Specialty: — Objective: Diagnostic/therapeutic accidents Background: Tumor necrosis factor (TNF)-α inhibitors are widely used for rheumatoid arthritis (RA). However, there are several risks to use TNFα inhibitors. Given the properties of TNF-α inhibitors, prevention and early detection of tuberculosis (TB) are especially important. Even among TNF-α inhibitors, the risk of TB infection differs according to each drug. The incidence of TB is lowest with etanercept (ETN). We present a case of urinary tract TB during treatment with ETN. Case Report: A 58-year-old woman was receiving ETN for RA. Before starting ETN, isoniazid (INH) prophylaxis was started. RA was well controlled by ETN. However, 32 months after starting ETN, she noticed urinary frequency and a sensation of residual urine. The diagnosis was elusive, and it took 3 months until urinary tract TB was finally diagnosed. The TB resolved with antituberculosis medication, but RA disease activity flared up after ETN was discontinued. ETN was resumed with careful monitoring for TB recurrence. After resuming ETN, the RA was again well controlled, with no recurrence of TB. Conclusions: Patients should be monitored for development of TB during ETN treatment, but ETN can be used safely with careful management. |
| Databáze: | OpenAIRE |
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