Dantes Elena, Tofolean Doina Ecaterina, Fildan Ariadna Petronela, Craciun Liviu, Dumea Elena, Tofolean Ioan Tiberiu, Mazilu Laura
1 Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania.
2 Pneumology Adults department I, Clinical Pulmonology Hospital of Constanta, Constanta, Romania.
J Int Med Res. 2018 Jul;46(7):2961-2969. doi: 10.1177/0300060518771273. Epub 2018 May 23.
Tumour necrosis factor (TNF)-α inhibitors are highly used in Romania for the treatment of autoimmune disorders, such as rheumatoid arthritis (RA), psoriasis, inflammatory bowel diseases, and ankylosing spondylitis. Biological therapy using TNF-α inhibitors is very effective but is associated with an increased risk of opportunistic infections, including active tuberculosis. Here, two cases are presented of patients with RA and psoriasis under biological therapy who developed very aggressive forms of disseminated tuberculosis, with a rapid progression to death. The authors conclude that patients undergoing biological therapy require thorough evaluation prior to initiating treatment, followed by continuous and rigorous monitoring by a multidisciplinary team during biological treatment, particularly in countries with a high incidence of tuberculosis.
肿瘤坏死因子（TNF）-α抑制剂在罗马尼亚被广泛用于治疗自身免疫性疾病，如类风湿性关节炎（RA）、牛皮癣、炎症性肠病和强直性脊柱炎。使用TNF-α抑制剂的生物疗法非常有效，但与机会性感染风险增加有关，包括活动性肺结核。本文介绍了两例接受生物疗法的RA和牛皮癣患者，他们发展为极具侵袭性的播散性肺结核形式，并迅速进展至死亡。作者得出结论，接受生物疗法的患者在开始治疗前需要进行全面评估，随后在生物治疗期间由多学科团队进行持续且严格的监测，尤其是在结核病高发国家。
