Krishnan V S Gokul, Madhyastha Sharath, Ramamoorthi Kusugodlu, Acharya Raviraj V, Gopalaswamy Vinaya
Department of Medicine, Kasturba Medical College, Manipal, Karnataka, India.
J Pharmacol Pharmacother. 2017 Jan-Mar;8(1):41-43. doi: 10.4103/jpp.JPP_174_16.
We present a case of pleural tuberculosis (TB) in a patient on infliximab for ankylosing spondylitis. A 36-year-old male presented to our hospital with low back ache of inflammatory type along with multiple symmetric inflammatory type of joint pain. Further clinical examination, laboratory and radiological investigations were suggestive of ankylosing spondylitis. He was initially treated with nonsteroidal anti-inflammatory drugs but citing poor response it was decided to initiate biologic therapy using infliximab (antitumor necrosis factor-alpha). Mantoux test and chest radiograph were done before the therapy to rule out TB. Following three doses of infliximab, patient came with complaints of fever and cough for 1 week. On investigation, it was found to be a case of pulmonary TB. This shows the importance of close monitoring of patient for TB among patients on infliximab even though the screening test has come out to be negative.
我们报告一例强直性脊柱炎患者在使用英夫利昔单抗治疗期间发生胸膜结核的病例。一名36岁男性因炎性下背痛及多处对称性炎性关节痛前来我院就诊。进一步的临床检查、实验室及影像学检查提示为强直性脊柱炎。他最初接受非甾体类抗炎药治疗，但因疗效不佳，决定开始使用英夫利昔单抗（抗肿瘤坏死因子-α）进行生物治疗。治疗前进行了结核菌素试验和胸部X线检查以排除结核。在使用三剂英夫利昔单抗后，患者出现发热和咳嗽症状1周。经检查，发现是一例肺结核病例。这表明，即使筛查试验结果为阴性，对于使用英夫利昔单抗的患者仍需密切监测是否发生结核。
