A case of lung tuberculosis in a patient with rheumatoid arthritis treated with infliximab after antituberculosis chemoprophylaxis with isoniazid.
We report a case of a 65-year-old man with rheumatoid arthritis. The patient was treated with methotrexate and prednisolone, but the disease activity remained high. A tuberculin skin test was positive. After antituberculosis (TB) chemoprophylaxis with isoniazid for four weeks, infliximab was administered. Chemoprophylaxis was continued for nine months. Active lung TB was diagnosed at 17 months after the cessation of isoniazid, namely at 27 months after starting infliximab treatment. This case report shows that TB can manifest after chemoprophylaxis in patients treated with antitumor necrosis factor agents.
Hirano
Yuji
Y
Department of Orthopaedic Surgery and Rheumatology, Nagoya University Graduate School of Medicine, Nagoya, Japan. yu-hr@sf.commufa.jp
Kojima
Toshihisa
T
Kanayama
Yasuhide
Y
Ishikawa
Hisato
H
Ishiguro
Naoki
N
D000368:Aged; D019072:Antibiotic Prophylaxis; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D000995:Antitubercular Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000382:microbiology / Q000601:surgery; D019645:Arthroplasty, Replacement, Knee; D006801:Humans; D016867:Immunocompromised Host; D000069285:Infliximab; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D014397:Tuberculosis, Pulmonary / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D000911:Antibodies, Monoclonal; D000995:Antitubercular Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab; D007538:Isoniazid