Krusiński Adam, Grzywa-Celińska Anna, Szewczyk Katarzyna, Grzycka-Kowalczyk Luiza, Emeryk-Maksymiuk Justyna, Milanowski Janusz
Chair and Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland.
Chair and Department of Pharmaceutical Botany, Medical University of Lublin, Lublin, Poland.
Int J Inflam. 2021 Jan 5;2021:6284987. doi: 10.1155/2021/6284987. eCollection 2021.
Although there are undeniable advantages of treatment of the inflammatory bowel diseases, Crohn's disease, and ulcerative colitis, with biological agents, the increased susceptibility to tuberculosis should not be ignored. Tuberculosis is an infectious disease caused by the which includes , , and . Primary tuberculosis is uncommon in the setting of inflammatory bowel disease: reactivation of latent tuberculosis is of greater concern. Consequently, latent infection should be excluded in patients who qualify for immunosuppressive treatments. Apart from the review of the literature, this article also presents three cases of different patterns of tuberculosis that occurred during treatment with infliximab, adalimumab, or vedolizumab. The first case reports a case of tuberculosis presenting as right middle lobe pneumonia. The second case featured miliary tuberculosis of the lungs with involvement of the mediastinal lymph nodes, liver, and spleen. The third patient developed a tuberculoma of the right parietal lobe and tuberculous meningitis. It is important to reiterate that every patient qualifying for a biologic agent should undergo testing to accurately identify latent tuberculosis, as well as precise monitoring for the possible development of one of the various forms or patterns of tuberculosis during treatment.
尽管使用生物制剂治疗炎症性肠病、克罗恩病和溃疡性结肠炎有不可否认的优势，但对结核病易感性增加的问题不容忽视。结核病是一种由[具体病原体未给出]引起的传染病，包括[具体类型未给出]、[具体类型未给出]和[具体类型未给出]。原发性结核病在炎症性肠病患者中并不常见：潜伏性结核病的重新激活更值得关注。因此，符合免疫抑制治疗条件的患者应排除潜伏感染。除了文献综述外，本文还介绍了3例在用英夫利昔单抗、阿达木单抗或维得利珠单抗治疗期间发生的不同类型结核病病例。第一例报告了1例表现为右中叶肺炎的结核病病例。第二例以肺部粟粒性结核伴纵隔淋巴结、肝脏和脾脏受累为特征。第三例患者出现右顶叶结核瘤和结核性脑膜炎。必须重申的是，每一位符合使用生物制剂条件的患者都应接受检测，以准确识别潜伏性结核病，并在治疗期间对可能出现的各种结核病形式或类型进行精确监测。
