Rheumatology Department, University College Hospital, 235 Euston Road, London, NW1 2BU, UK.
Clin Rheumatol. 2011 Mar;30(3):399-401. doi: 10.1007/s10067-010-1605-1. Epub 2010 Oct 23.
Reactivation of latent tuberculosis (TB) is an established risk of anti-tumour necrosis factor α (anti-TNF) therapy. We report five cases of active TB occurring in 703 patients treated with anti-TNF therapy over a 10-year period in a central London hospital and review our screening practices for identifying latent TB prior to anti-TNF treatment. Four patients were receiving adalimumab and one patient etanercept at the time of TB diagnosis. Four of the five patients were born in countries with a high TB prevalence. Two of the five patients were healthcare workers. All patients had normal chest radiographs prior to anti-TNF treatment. Our data emphasise that country of origin is important in the determining risk of latent TB and that a normal chest radiograph does not exclude latent TB.
潜伏性结核（TB）的再激活是抗肿瘤坏死因子α（anti-TNF）治疗的既定风险。我们报告了在伦敦市中心医院接受抗 TNF 治疗的 703 例患者中，10 年内发生的 5 例活动性 TB，并回顾了我们在开始抗 TNF 治疗前识别潜伏性 TB 的筛查实践。在 TB 诊断时，有 4 名患者正在接受阿达木单抗治疗，1 名患者正在接受依那西普治疗。这 5 名患者中有 4 名出生于结核病高发国家。其中 2 名患者是医务人员。所有患者在开始抗 TNF 治疗前的胸部 X 线检查均正常。我们的数据强调，原籍国在确定潜伏性 TB 的风险方面很重要，并且正常的胸部 X 线检查不能排除潜伏性 TB。
