Prolonged paradoxical reaction to antituberculous treatment after discontinuation of TNF-alpha- blocker therapy with adalimumab. Rare clinical documentation

• Autorzy: Roger Fei Falkenstern-Ge , Kim Husemann , Martin Kohlhäufl
• Języki publikacji: EN

Abstrakty

EN

In the past decades, tumor necrosis factor alpha (TNF-a) antagonist has been a milestone in the treatment of many chronic inflammatory diseases. TNF antagonist can increase patients´ susceptibility to many different kinds of infections especially those requiring granuloma formations despite regular performance of Screening for latent tuberculosis infection (LTBI). We report 2 cases of patients who developed tuberculosis under treatment with adalimumab, which was discontinued after the diagnosis of tuberculosis. During the tuberculosis therapy they unexpectedly developed a prolonged paradoxical reaction. In both cases we were only able to manage the progress of the paradoxical reaction through high steroid doses. Patients undergoing therapy with TNF- alphablocker are prone to develop tuberculosis infection, which could in turn lead to severe prolonged paradoxical reaction during anti-tuberculous treatment. An increased steroid dose may be required and is sometimes necessary

Słowa kluczowe

EN

Adalimumab; Paradoxical reaction; IRIS (immune reconstitution inflammatory syndrome); SAPHO (synovitis; acne; pustulosis; hyperostosis; osteitis) syndrome; latent tuberculosis infection (LTBI); Tuberculosis (TB); IGRA (Interferon Gamma Release Assay); TNF (tumor necrosis factor)

• Czasopismo: Open Medicine
• Rocznik: 2014
• Tom: 10
• Numer: 1

Daty

wydano

2015-01-01

otrzymano

2013-04-28

zaakceptowano

2014-01-08

online

2014-10-08

Twórcy

autor

Roger Fei Falkenstern-Ge

• Klinik Schillerhoehe/ RBK, Gerlingen- Stuttgart, Baden- Wuerttemberg, Germany,

autor

Kim Husemann

• Division of Pulmonology, Klinik Schillerhoehe, Center for Pulmonology and Thoracic Surgery, Teaching Hospital of the University of Tuebingen, Solitude Str. 18, 70839 Stuttgart- Gerlingen, Germany,

autor

Martin Kohlhäufl

• Division of Pulmonology, Klinik Schillerhoehe, Center for Pulmonology and Thoracic Surgery, Teaching Hospital of the University of Tuebingen, Solitude Str. 18, 70839 Stuttgart- Gerlingen, Germany,

Bibliografia

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Identyfikatory

DOI

10.1515/med-2015-0009