title: A case of preventable pulmonary tuberculosis in a Greenlandic, heavily immune suppressed patient.
abstract: Immune modulating therapy, such as tumour necrosis factor (TNF)-alpha inhibitors, is becoming increasingly more widespread in the treatment of many autoimmune diseases. One of the well-documented side effects of TNF-alpha inhibitors is an increased risk of reactivating latent tuberculosis infection (LTBI). Diagnostic tools available for diagnosing LTBI lack sensitivity and specificity. We report the case of a rheumatoid arthritis (RA) patient at high-risk of reactivation of LTBI, who should have been offered prophylactic anti-tuberculous treatment on two separate occasions: firstly, before initiating anti-TNF-α treatment and secondly, as part of routine tuberculosis contact tracing. He subsequently developed severe pulmonary tuberculosis and was hospitalised for 6 weeks.
authors.affiliation: Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100 København Ø, Denmark.
authors.forename: Anne-Sophie H
authors.initials: AS
authors.lastname: Christensen
authors.affiliation: Department of Infectious Diseases, Odense University Hospital, Odense, Denmark.
authors.forename: Isik S
authors.initials: IS
authors.lastname: Johansen
keywords: Biologics; Rheumatoid arthritis; Screening; Tuberculosis