title: [Intracerebral lesions after TNF-alpha inhibitor therapy with pre-existing sarcoidosis and sacroiliitis].
abstract: This article reports the case of a 55-year-old man who presented with aphasia caused by intracerebral lesions and had a history of pulmonary sarcoidosis. Due to nonsteroidal anti-inflammatory drug-resistant spondyloarthritis TNF-alpha inhibitor treatment was started after a negative tuberculosis screening. Subsequently the patient developed pulmonary tuberculosis and cerebral tuberculoma reactivated by the TNF-alpha inhibitor therapy accompanied by pulmonary sarcoidosis with sacroiliitis and oligoarthritis. This case report emphasises the risk of atypical tuberculosis infections under TNF-alpha inhibitors despite negative results of tuberculosis screening.
authors.affiliation: Klinikum München-Bogenhausen, Klinik für Rheumatologie und klinische Immunologie, Lehrkrankenhaus der Technischen Universität München, Englschalkinger Str. 77, 81925, München, Deutschland. Helga.Merwald-Fraenk@klinikum-muenchen.de
authors.forename: H
authors.initials: H
authors.lastname: Merwald-Fraenk
authors.forename: B
authors.initials: B
authors.lastname: Piper
authors.forename: H
authors.initials: H
authors.lastname: Mörtlbauer
authors.forename: M
authors.initials: M
authors.lastname: Welcker
authors.forename: I I
authors.initials: II
authors.lastname: Vallbracht-Ackermann
mesh_terms: D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D058566:Sacroiliitis / Q000150:complications* / Q000188:drug therapy; D012507:Sarcoidosis / Q000150:complications* / Q000188:drug therapy; D016896:Treatment Outcome; D016862:Tuberculoma, Intracranial / Q000139:chemically induced* / Q000175:diagnosis*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D000893:Anti-Inflammatory Agents; D014409:Tumor Necrosis Factor-alpha