Pennington Kelly, Sasieta Humberto C, Ramos Guiherme P, Erskine Courtney L, Van Keulen Virginia P, Peikert Tobias, Escalante Patricio
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA.
Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Clin Med Insights Case Rep. 2017 Aug 24;10:1179547617724776. doi: 10.1177/1179547617724776. eCollection 2017.
Tumor necrosis factor α antagonists are increasingly used to treat inflammatory and autoimmune disorders and are associated with increased risk of active tuberculosis. Diagnosis of active tuberculosis in patients taking tumor necrosis factor α antagonists can be challenging owing to increased incidence of extrapulmonary manifestations and false-negative results on current available diagnostic tests. We present a case of a young woman on infliximab for ulcerative colitis who presented with disseminated tuberculosis. As part of a research study, we performed flow cytometric immune profiling, which has previously not been reported in patients with active tuberculosis taking tumor necrosis α antagonists. The flow cytometry results were within the positive thresholds for tuberculosis infection. Flow cytometric immune profiling may be a valid diagnostic tool for patients taking tumor necrosis factor α antagonists.
肿瘤坏死因子α拮抗剂越来越多地用于治疗炎症性和自身免疫性疾病，且与活动性结核病风险增加相关。对于正在服用肿瘤坏死因子α拮抗剂的患者，由于肺外表现的发生率增加以及现有诊断测试出现假阴性结果，活动性结核病的诊断可能具有挑战性。我们报告了一例年轻女性溃疡性结肠炎患者，使用英夫利昔单抗治疗，出现播散性结核病。作为一项研究的一部分，我们进行了流式细胞术免疫分析，此前尚未见在服用肿瘤坏死因子α拮抗剂的活动性结核病患者中进行此类分析的报道。流式细胞术结果在结核病感染的阳性阈值范围内。流式细胞术免疫分析可能是服用肿瘤坏死因子α拮抗剂患者的一种有效诊断工具。
