Clinical characteristics and treatment responses of patients who developed tuberculosis following use of a tumor necrosis factor-alpha inhibitor.
10.3904/kjim.2013.28.2.174
- Author:
Keun Bum CHUNG
1
;
Eun Young LEE
;
Jong Pil IM
;
Sung Koo HAN
;
Jae Joon YIM
Author Information
1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. yimjj@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Tumor necrosis factor-alpha;
Tuberculosis;
Mycobacterium
- MeSH:
Adult;
Aged;
Antitubercular Agents/therapeutic use;
Female;
Humans;
*Immunocompromised Host;
Immunosuppressive Agents/*adverse effects;
Interferon-gamma Release Tests;
Male;
Middle Aged;
Retrospective Studies;
Risk Factors;
Time Factors;
Treatment Outcome;
Tuberculin Test;
Tuberculosis/diagnosis/drug therapy/*immunology/microbiology;
Tumor Necrosis Factor-alpha/*antagonists & inhibitors
- From:The Korean Journal of Internal Medicine
2013;28(2):174-179
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Individuals being treated with tumor necrosis factor (TNF)-alpha inhibitors are at increased risk of developing tuberculosis (TB). We determined the clinical characteristics and treatment response of patients who developed TB after using TNF-alpha inhibitors. METHODS: Patients with TB detected within 12 months of the initiation of TNF-alpha inhibitor treatment were included, if seen from January 1, 2000 to August 31, 2011. We retrospectively reviewed the clinical records, results of bacteriological examinations, and radiographs of the included patients and the response to anti-TB treatment. RESULTS: We indentified seven cases of TB in 457 patients treated with TNF-alpha inhibitors during the study period. TB developed a median of 123 days (range, 48 to 331) after the first dose of TNF-alpha inhibitor. Pulmonary TB, including TB pleuritis, was diagnosed in three patients and extrapulmonary TB in four. Favorable treatment outcomes were achieved in six of seven patients. CONCLUSIONS: Among the TNF-alpha inhibitor users who contracted TB, extrapulmonary sites were common and the treatment response was satisfactory.
