Pulmonary Tuberculosis After Therapy with Anti-Tumor Necrosis Factor (TNF) for Crohn Disease: A Case Report
| Autor: | Bruna Helena de Oliveira Santos, Rogerio Saad-Hossne, Giedre Soares Prates Herrerias, Erika Mayumi Watanabe, Douglas Inomata Cardoso da Silva, Fernanda Lofiego Renosto, Julio Pinheiro Baima, Ligia Yukie Sassaki |
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| Přispěvatelé: | Universidade Estadual Paulista (UNESP) |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Tuberculosis Population Inflammatory bowel disease chemistry.chemical_compound Crohn Disease Mesalazine Latent Tuberculosis Internal medicine Adalimumab medicine Humans education Tuberculosis Pulmonary education.field_of_study Latent tuberculosis Tumor Necrosis Factor-alpha business.industry Articles General Medicine Inflammatory Bowel Diseases medicine.disease Infliximab chemistry Chemoprophylaxis Tumor Necrosis Factor Inhibitors business medicine.drug |
| Zdroj: | The American Journal of Case Reports Scopus Repositório Institucional da UNESP Universidade Estadual Paulista (UNESP) instacron:UNESP |
| ISSN: | 1941-5923 |
| DOI: | 10.12659/ajcr.932963 |
| Popis: | Made available in DSpace on 2022-04-29T08:33:21Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Background: Challenging differential diagnosis Adalimumab is a biological anti-tumor necrosis factor (TNF) agent which induces and maintains remission in patients with moderate-to-severe Crohn disease (CD). An adverse effect of its use is reactivation of latent in-fections, such as tuberculosis (TB). TB is caused by Mycobacterium tuberculosis and continues to be an impor-tant public health problem in some developing countries, such as Brazil. The present report describes the case of a patient with CD who developed pulmonary TB while receiving adalimumab therapy. A 38-year-old penitentiary worker presented with colonic CD that was intolerant to azathioprine and was started on adalimumab. After 3 months, he experienced coughing, fever, and weight loss, and was diagnosed with pulmonary TB. A chest X-ray and tuberculin skin test performed before he started taking adalimumab were negative for latent TB. The patient was treated for 9 months to cure his infection. The use of adalimumab was suspended while the TB was investigated and he took mesalazine to achieve clinical and endoscopic remission of CD. Adequate screening and chemoprophylaxis for latent TB are indicated in patients at high risk of infection. In patients with inflammatory bowel disease, after anti-TNF therapy is started, strict monitoring is required so that opportunistic infections can be detected early and morbidity and mortality reduced in this population. Department of Internal Medicine São Paulo State University (UNESP) Medical School Department of Radiology São Paulo State University (UNESP) Medical School Department of Surgery São Paulo State University (UNESP) Medical School Department of Internal Medicine São Paulo State University (UNESP) Medical School Department of Radiology São Paulo State University (UNESP) Medical School Department of Surgery São Paulo State University (UNESP) Medical School |
| Databáze: | OpenAIRE |
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