Tuberculosis and anti-TNF treatment: experience of a central London hospital.
Reactivation of latent tuberculosis (TB) is an established risk of anti-tumour necrosis factor α (anti-TNF) therapy. We report five cases of active TB occurring in 703 patients treated with anti-TNF therapy over a 10-year period in a central London hospital and review our screening practices for identifying latent TB prior to anti-TNF treatment. Four patients were receiving adalimumab and one patient etanercept at the time of TB diagnosis. Four of the five patients were born in countries with a high TB prevalence. Two of the five patients were healthcare workers. All patients had normal chest radiographs prior to anti-TNF treatment. Our data emphasise that country of origin is important in the determining risk of latent TB and that a normal chest radiograph does not exclude latent TB.
Mankia
Satveer
S
Rheumatology Department, University College Hospital, 235 Euston Road, London, NW1 2BU, UK. satveer.mankia@gmail.com
Peters
James E
JE
Kang
Swan
S
Moore
Samantha
S
Ehrenstein
Michael R
MR
D018501:Antirheumatic Agents / Q000009:adverse effects*; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects*; D055985:Latent Tuberculosis / Q000139:chemically induced; D008131:London; D018124:Receptors, Tumor Necrosis Factor; D014376:Tuberculosis / Q000209:etiology / Q000503:physiopathology
D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept