Keizer Sytze, Gerritsen Roald, Jauw Yvonne, Janssen Jeroen, Koopman Bart, Bresser Paul
Gemeentelijke Gezondheidsdienst Amsterdam, afd. Tuberculosebestrijding, Amsterdam.
Ned Tijdschr Geneeskd. 2015;159:A8650.
Two patients, 68 and 72 years old, were admitted with fever whilst under treatment with ruxolitinib for myelofibrosis. They had not been screened for latent tuberculosis infection (LTBI) and extensive tuberculosis was found in both patients. They died within weeks from complications of fulminant disease.
Doctors who prescribe ruxolitinib should be aware of the increased risk of infectious diseases like tuberculosis. Under immune suppression, tuberculosis often runs a disseminated course. The constitutional symptoms of myelofibrosis strongly resemble those of tuberculosis and the latter diagnosis should always be considered. Active and latent tuberculosis should be excluded and treated, if necessary, before giving ruxolitinib.
两名患者，年龄分别为68岁和72岁，在接受芦可替尼治疗骨髓纤维化期间出现发热症状而入院。他们未接受过潜伏性结核感染（LTBI）筛查，两名患者均被发现患有广泛的结核病。他们在数周内死于暴发性疾病的并发症。
开具芦可替尼的医生应意识到结核病等传染病风险增加。在免疫抑制状态下，结核病通常呈播散性病程。骨髓纤维化的全身症状与结核病极为相似，应始终考虑后者的诊断。在给予芦可替尼之前，应排除活动性和潜伏性结核病，必要时进行治疗。
