Central nervous system manifestations of tuberculosis-associated immune reconstitution inflammatory syndrome during adalimumab therapy: a case report and review of the literature.
Intern Med
; 54(7): 847-51, 2015.
Article
de En
| MEDLINE
| ID: mdl-25832955
ABSTRACT
A 64-year-old neurologically asymptomatic woman with rheumatoid arthritis who was treated with the tumor necrosis factor (TNF)-α antagonist adalimumab developed disseminated tuberculosis (TB). After receiving anti-TB therapy and discontinuing adalimumab, she exhibited paradoxical worsening due to immune reconstitution inflammatory syndrome (IRIS) with the appearance of meningitis and brain tuberculomas. This case indicates that continuing anti-TNF therapy may be necessary to prevent IRIS in patients who develop TB, particularly disseminated TB, during the course of anti-TNF therapy. In addition, careful screening for central nervous system (CNS) TB should be performed prior to the initiation of therapy, as even neurologically asymptomatic patients can develop CNS manifestations of IRIS.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Méningite tuberculeuse
/
Tuberculome intracrânien
/
Syndrome inflammatoire de restauration immunitaire
/
Anticorps monoclonaux humanisés
/
Anti-inflammatoires
Type d'étude:
Risk_factors_studies
Limites:
Female
/
Humans
/
Middle aged
Langue:
En
Journal:
Intern Med
Sujet du journal:
MEDICINA INTERNA
Année:
2015
Type de document:
Article
Pays d'affiliation:
Japon