Department of Clinical Hematology, King George's Medical University, Lucknow, India.
Department of Clinical Hematology, King George's Medical University, Lucknow, India.
Indian J Tuberc. 2022 Jul;69(3):354-358. doi: 10.1016/j.ijtb.2021.06.003. Epub 2021 Jun 26.
JAK 2 inhibitors are widely used for the treatment of primary myelofibrosis. Ruxolitinib is the most commonly used JAK inhibitor in clinical practice. We report two cases of Primary Myelofibrosis who developed tuberculosis on active treatment with ruxolitinib. Our first case was a 48 year male who developed disseminated tuberculosis during fourth month of treatment and second case was a 50 year male developing tubercular lymphadenitis during second month of treatment respectively. These case reports indicate reactivation of underling tubercular infection as a very dreaded complication of this treatment. The prevalence of tuberculosis is much higher in India compared to the west. A thorough pretreatment evaluation should ideally be done using Mantoux test or interferon gamma release assay (IGRA) to rule out latent tuberculosis. Furthermore, the patients should be counselled regarding the possibility of reactivation of infections including tuberculosis. Also, proper follow up is the need of hour in all patients on any kind of immunomodulators.
JAK2 抑制剂被广泛用于原发性骨髓纤维化的治疗。鲁索替尼是临床实践中最常用的 JAK 抑制剂。我们报告了两例原发性骨髓纤维化患者，他们在接受鲁索替尼积极治疗时发生了结核病。我们的第一个病例是一名 48 岁男性，在治疗第四个月时发生了播散性结核病，第二个病例是一名 50 岁男性，在治疗第二个月时发生了结核性淋巴结炎。这些病例报告表明，潜在的结核感染的复发是这种治疗的一个非常可怕的并发症。与西方相比，结核病在印度的发病率要高得多。理想情况下，应使用结核菌素试验或干扰素γ释放试验（IGRA）进行彻底的预处理评估，以排除潜伏性结核。此外，应告知患者存在包括结核病在内的感染复发的可能性。此外，所有接受任何类型免疫调节剂治疗的患者都需要进行适当的随访。
