[Case of miliary tuberculosis during treatment with infliximab for rheumatoid arthritis].
A 70-year-old woman afflicted with rheumatoid arthritis was consulted another hospital because of fever and abnormality in chest X-ray. She had been treated with methotrexate and infliximab for seven months. She was diagnosed as methotrexate-induced pneumonia, and was administrated large therapeutic doses of corticosteroid, but finding of her chest X-ray exacerbated. Her sputum examination was positive for Mycobacterium tuberculosis complex by nucleic-acid amplification test, and she was diagnosed as miliary tuberculosis. She was treated with INH, RFP, EB, and PZA, and showed good clinical response to treatment. When infliximab is prescribed, we have to bear in mind possible complication of tuberculosis.
Taniguchi
Hirokazu
H
Department of Internal Medicine, Toyama Prefectural Central Hospital, 2-2-78, Nishinagae, Toyama-shi, Toyama 930-8550, Japan. tan@tch.pref.toyama.jp
Izumi
Saburo
S
D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000008:administration & dosage; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D000069285:Infliximab; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D014391:Tuberculosis, Miliary / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D000995:Antitubercular Agents; D000069285:Infliximab; D008727:Methotrexate