Abstract
Tumor necrosis factor α antagonist therapies represent an increased risk of reactivation of tuberculosis. We report two cases of life-threatening disseminated tuberculosis in patients undergoing treatment with infliximab for Crohn's disease including one case of a patient with cerebral tuberculomas. We discuss the implication of tumor necrosis factor α in the genesis of tuberculosis infection and the features of tuberculosis under infliximab. Tuberculosis screening and eventually preventive chemotherapy should become the standard of care for individual undergoing tumor necrosis factor α antagonist therapies.
Copyright © 2012. Published by Elsevier B.V.
MeSH terms
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Adult
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Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
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Antibodies, Monoclonal / adverse effects*
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Brain Diseases / drug therapy
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Brain Diseases / etiology*
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Cerebrum
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Crohn Disease / complications
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Crohn Disease / drug therapy*
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Humans
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Infliximab
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Male
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Middle Aged
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Mycobacterium tuberculosis
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Recurrence
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Tuberculoma / drug therapy
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Tuberculoma / etiology*
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Tuberculoma, Intracranial / drug therapy
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Tuberculoma, Intracranial / etiology
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Tuberculosis, Miliary / drug therapy
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Tuberculosis, Miliary / etiology*
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Tumor Necrosis Factor-alpha / antagonists & inhibitors
Substances
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Anti-Inflammatory Agents, Non-Steroidal
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Antibodies, Monoclonal
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Tumor Necrosis Factor-alpha
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Infliximab