title: Disseminated Tuberculosis Resulting From Reinfection in a Pediatric Patient Sequentially Treated With Etanercept and Adalimumab.
abstract: Treatment with tumor necrosis factor α inhibitors is a risk factor for tuberculosis (TB). Despite previous treatment with isoniazid for latent TB, a 9-year-old girl with juvenile idiopathic arthritis developed disseminated TB after changing therapy with etanercept to adalimumab and after new contact with a smear-positive relative. Genotyping strain matches and susceptibility to isoniazid make reinfection more likely than reactivation in our patient.
authors.affiliation: From the *Infectious Diseases Unit, Pediatrics Department, Miguel Servet University Hospital-University of Zaragoza, Zaragoza, Spain; †Malalties infeccioses i resposta inflamatòria sistèmica en pediatria, Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain; ‡Department of Orthopedic Surgery and Traumatology, Miguel Servet University Hospital-University of Zaragoza, Zaragoza, Spain; §Rheumatology Unit, Pediatrics Department, Miguel Servet University Hospital-University of Zaragoza, Zaragoza, Spain; ¶Departament de Pediatria, Universitat de Barcelona, Barcelona, Spain; and ‖CIBER de Epidemiología y Salud Pública, Ciberesp, Spain.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Guerrero-Laleona
authors.forename: Joan
authors.initials: J
authors.lastname: Calzada-Hernández
authors.forename: Matilde
authors.initials: M
authors.lastname: Bustillo-Alonso
authors.forename: Jorge
authors.initials: J
authors.lastname: Gil-Albarova
authors.forename: Marta
authors.initials: M
authors.lastname: Medrano-San Ildefonso
authors.forename: Estibaliz
authors.initials: E
authors.lastname: Iglesias-Jiménez
authors.forename: Antoni
authors.initials: A
authors.lastname: Noguera-Julian
mesh_terms: D000068879:Adalimumab / Q000009:adverse effects* / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000150:complications / Q000188:drug therapy*; D002648:Child; D000068800:Etanercept / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005838:Genotype; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000235:genetics; D014376:Tuberculosis / Q000209:etiology* / Q000382:microbiology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000893:Anti-Inflammatory Agents; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab; D000068800:Etanercept