Artritis reumatoide tratada con inhibidores del factor de necrosis tumoral á (Anti-TNF-á) y tuberculosis pulmonar / Rheumatoid Arthritis treatment based in inhibitor of tumoral necrosis factor (Anti-TNF) and pulmonary tuberculosis

RESUMEN

Presentación de una paciente con artritis reumatoide severa en tratamiento con inhibidoresdel Factor de Necrosis Tumoral (Anti-TNF), quien presenta además un cuadro de tuberculosispulmonar. /This paper shows a patient with severe rheumatoid arthritis in treatment with Anti TumuralNecrosis Factor (Anti TNF therapy), who also present pulmonary tuberculosis.The rheumatoid arthritis is a chronic inflammatory disease of the articulations that at firstaffects the synovial membrane, but if it is not treated appropriately it degenerates into irreversiblestructural damage of the muscle-skeletal system and possibly of other organic systems. Theclassification criteria of the American College of Rheumatology includes the Morning Stiffness,Arthritis of 3 or more joints, symmetrical Arthritis, rheumatic Nodules, Rheumatoid Factorand Radiographic findings. Inside the pathology of this illness the factor of necrosis tumoral is acytocine that plays an important role, a high production of TNF has been found in the synovial ofthese patients, and for its capacity to induce the production of other citocinas, as IL-6, IL-17, GMCSF,M-CSF, and even IL-1 and TNF - (autocrine function), it would seem that the TNF it exercisesan action “hierarchical” inside the call citocynes net and an inhibition of its action gives, as aresult, a therapeutic benefit in the patients with RA. However it is well-known that the concurrentbut frequently informed infection with the use of biological agents is the TB, and the incidence ofthis it has been increased from the coming of the biological therapy. Therefore the description ofthis case doesn’t correspond to an isolated medical fact, but to a current and real problem. Thisis the first case in the Caribbean Coast.