[A case of pulmonary tuberculosis and tuberculous pleuritis during treatment with etanercept for rheumatoid arthritis].
A 64-year-old woman, afflicted with rheumatoid arthritis, consulted our hospital because of her clinical deterioration. Her doctor started treating her with etanercept and prednisolone 10 mg/day but without preventive chemotherapy for tuberculosis, because her chest CT showed only mild interstitial pneumonia, and her tuberculin test showed a slightly-positive reaction. Her symptoms improved, but her chest X-ray showed infiltration after two and a half months treatment, and right pleural effusion after four and a half months treatment. A diagnosis of pulmonary tuberculosis and tuberculous pleuritis was made because of an increase of adenosine deaminase in pleural effusion. She was treated with isoniazid, rifampicin, and ethambutol, resulting in a successful clinical course. Her sputum culture was positive, and a nucleic-acid amplification of Mycobacterium tuberculosis complex was positive. When prescribing etanercept, we should pay close attention to the possibility of tuberculosis.
Taniguchi
Hirokazu
H
Department of Internal Medicine, Toyama Prefectural Central Hospital.
Inomata
Minehiko
M
Abo
Hitoshi
H
Izumi
Saburo
S
D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects*; D008875:Middle Aged; D018124:Receptors, Tumor Necrosis Factor; D014396:Tuberculosis, Pleural / Q000139:chemically induced*; D014397:Tuberculosis, Pulmonary / Q000139:chemically induced*
D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept