Tuberculous pleurisy diagnosed by medical thoracoscopy in an adalimumab-treated rheumatoid arthritis patient after treatment of latent tuberculosis infection.
A 28-year-old rheumatoid arthritis woman treated with adalimumab was admitted with fever, cough, and right chest pain. X-ray showed right pleural effusion. By medical thoracoscopy, diffuse white nodules were observed, and biopsy specimen demonstrated epithelioid cell granulomas with necrosis and auramine-stained organisms, which suggested a diagnosis of tuberculous pleurisy. Medical thoracoscopy can be a potent diagnostic method when tuberculous pleurisy is suspected. Notably, despite latent tuberculosis treatment, active tuberculosis was not prevented.
Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongou, Bunkyo-ku, Tokyo, 113-8655, Japan.
Yasuo
Y
Nagafuchi
Hirofumi
H
Shoda
Keishi
K
Fujio
Satoru
S
Ishii
Haruhito
H
Sugiyama
Kazuhiko
K
Yamamoto
D000068879:Adalimumab; D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D055985:Latent Tuberculosis / Q000188:drug therapy*; D013906:Thoracoscopy; D014396:Tuberculosis, Pleural / Q000150:complications / Q000175:diagnosis*
D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D000995:Antitubercular Agents; D000068879:Adalimumab; D007538:Isoniazid