title: Cerebral tuberculomas in a patient with hairy cell leukaemia treated with cladribine.
abstract: A 67-year-old man was treated with cladribine for hairy cell leukaemia. A few weeks later, he presented with persistent headaches, intermittent hypoesthesia of the right upper limb and language impairment. Brain CT scan showed 3 contrast-enhancing lesions. MRI revealed infracentimetric nodular lesions with restricted diffusion. One of the lesions was surgically removed and tested positive for acid-fast bacilli. Moreover, Mycobacterium tuberculosis was confirmed by PCR. Antituberculous drugs were prescribed for 12 months, with complete resolution of neurological deficits. This case highlights the risk of mycobacterial infections associated with both hairy cell leukaemia and cladribine use, and the importance of screening and treatment of latent forms of tuberculosis in patients undergoing treatment with immunosuppressive drugs.
authors.affiliation: Department of Internal Medicine, Centro Hospitalar do Porto-Hospital de Santo António, Porto, Portugal.
authors.forename: Samuel Barbosa
authors.initials: SB
authors.lastname: Fonseca
authors.affiliation: Department of Internal Medicine, Centro Hospitalar do Porto-Hospital de Santo António, Porto, Portugal.
authors.forename: Júlio Rodrigues
authors.identifier: http://orcid.org/0000-0002-4206-8826
authors.initials: JR
authors.lastname: de Oliveira
authors.affiliation: Department of Haematology, Centro Hospitalar do Porto-Hospital de Santo António, Porto, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Gonçalves
authors.affiliation: Department of Microbiology, Centro Hospitalar do Porto-Hospital de Santo António, Porto, Portugal.
authors.forename: Virgínia
authors.initials: V
authors.lastname: Lopes
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D017338:Cladribine / Q000627:therapeutic use*; D005625:Frontal Lobe / Q000000981:diagnostic imaging*; D006801:Humans; D007943:Leukemia, Hairy Cell / Q000150:complications / Q000188:drug therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D016862:Tuberculoma, Intracranial / Q000150:complications* / Q000175:diagnosis
chemical_list: D000970:Antineoplastic Agents; D017338:Cladribine