Rituximab for Rheumatoid Arthritis Following TNF-alpha Inhibitor Associated Splenic Tuberculosis.
10.4078/jrd.2013.20.2.108
- Author:
Jin Su KIM
1
;
Jung Ran CHOI
;
Jung Soo SONG
;
Kyung Joon KIM
;
Youn Su PARK
;
Jun Hwan CHO
;
Min Jee HAN
;
Sang Tae CHOI
Author Information
1. Division of Rheumatology, Department of Internal Medicine, Chung-Ang University School of Medicine, Seoul, Korea. beconst@cau.ac.kr
- Publication Type:Case Report
- Keywords:
Splenic tuberculosis;
TNF-alpha inhibitor;
Rituximab;
Rheumatoid arthritis
- MeSH:
Antibodies, Monoclonal, Murine-Derived;
Arthritis, Rheumatoid;
Humans;
Lung;
Tuberculosis;
Tuberculosis, Splenic;
Tumor Necrosis Factor-alpha;
Rituximab
- From:Journal of Rheumatic Diseases
2013;20(2):108-112
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
One of the most important adverse effects of a tumor necrosis factor (TNF)-alpha inhibitor is the reactivation of tuberculosis. Most of them occur in the lung, but sometimes they can be found in other organs. Moreover, the proper management of active rheumatoid arthritis (RA) in patients with anti-TNF-alpha associated tuberculosis is still in debate. We present the case of a seropositive RA patient who showed good response with rituximab, an anti-CD20 monoclonal antibody, after developing splenic tuberuculosis, following treatment with TNF-alpha inhibitor. Confirming a diagnosis of splenic tuberculosis is difficult and can be delayed due to its nonspecific symptoms and rare occurrence. This case suggests that splenic tuberculosis should be doubted in RA patients treated with TNF-alpha inhibitor, and that rituximab may be considered as an alternative treatment option in RA patients with anti-TNF-alpha associated tuberculosis.
