Guerrero-Laleona Carmelo, Calzada-Hernández Joan, Bustillo-Alonso Matilde, Gil-Albarova Jorge, Medrano-San Ildefonso Marta, Iglesias-Jiménez Estibaliz, Noguera-Julian Antoni
From the *Infectious Diseases Unit, Pediatrics Department, Miguel Servet University Hospital-University of Zaragoza, Zaragoza, Spain; †Malalties infeccioses i resposta inflamatòria sistèmica en pediatria, Institut de Recerca Pediàtrica Hospital Sant Joan de Déu, Barcelona, Spain; ‡Department of Orthopedic Surgery and Traumatology, Miguel Servet University Hospital-University of Zaragoza, Zaragoza, Spain; §Rheumatology Unit, Pediatrics Department, Miguel Servet University Hospital-University of Zaragoza, Zaragoza, Spain; ¶Departament de Pediatria, Universitat de Barcelona, Barcelona, Spain; and ‖CIBER de Epidemiología y Salud Pública, Ciberesp, Spain.
Pediatr Infect Dis J. 2017 Jan;36(1):109-110. doi: 10.1097/INF.0000000000001360.
Treatment with tumor necrosis factor α inhibitors is a risk factor for tuberculosis (TB). Despite previous treatment with isoniazid for latent TB, a 9-year-old girl with juvenile idiopathic arthritis developed disseminated TB after changing therapy with etanercept to adalimumab and after new contact with a smear-positive relative. Genotyping strain matches and susceptibility to isoniazid make reinfection more likely than reactivation in our patient.
使用肿瘤坏死因子α抑制剂进行治疗是发生结核病（TB）的一个危险因素。尽管该9岁患有幼年特发性关节炎的女孩之前接受过异烟肼治疗潜伏性结核，但在将依那西普治疗改为阿达木单抗治疗后，以及在与一名涂片阳性的亲属有新接触后，发生了播散性结核。基因分型菌株匹配以及对异烟肼的敏感性表明，在我们的患者中，再次感染比复发更有可能。
