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一名强直性脊柱炎患者在接受肿瘤坏死因子(TNF)-α抑制剂治疗时发生播散性结核病:病例报告

Disseminated Tuberculosis in a Patient on Tumor Necrosis Factor (TNF)-α Inhibitor Treatment for Ankylosing Spondylitis: A Case Report.

作者信息

Fadl Lana, Abdelgadir Arowa, Mirza Hibah, Mahreen Aqsa, Thaplar G Gouda Siddalingana Gouda

机构信息

Internal Medicine, Walsall Healthcare NHS Trust, Walsall, GBR.

Internal Medicine, Royal Hampshire County Hospital, Winchester, GBR.

出版信息

Cureus. 2024 Oct 31;16(10):e72796. doi: 10.7759/cureus.72796. eCollection 2024 Oct.

Abstract

Tumour necrosis factor-alpha (TNF-α) inhibitors are commonly used in the treatment of ankylosing spondylitis (AS) due to their effectiveness in reducing inflammation and slowing disease progression. However, their use is associated with an increased risk of opportunistic infections, particularly tuberculosis (TB). This case report presents a young male patient in the United Kingdom (UK) with AS, who had been on long-term biological therapy with adalimumab, a TNF-α inhibitor. The patient developed disseminated TB, which rapidly progressed and unfortunately resulted in the patient's death. This case underscores the importance of comprehensive screening for latent TB before initiating TNF-α inhibitor therapy, as well as ongoing monitoring throughout treatment. Given the multicultural nature of the UK, where individuals may be exposed to TB without traveling to endemic areas, careful attention to TB risk across all ethnicities is critical. This case highlights the need for heightened vigilance and tailored preventive strategies to mitigate the risks of TNF-α therapy.

摘要

肿瘤坏死因子-α(TNF-α)抑制剂因其在减轻炎症和减缓疾病进展方面的有效性,常用于治疗强直性脊柱炎(AS)。然而,使用这些药物会增加机会性感染的风险,尤其是结核病(TB)。本病例报告介绍了一名英国的年轻男性AS患者,他长期接受TNF-α抑制剂阿达木单抗的生物治疗。该患者发生了播散性结核病,病情迅速进展,不幸导致患者死亡。本病例强调了在开始TNF-α抑制剂治疗前进行潜伏性结核全面筛查以及在整个治疗过程中持续监测的重要性。鉴于英国的多元文化性质,在那里个人可能在未前往流行地区的情况下接触到结核病,对所有种族的结核病风险给予密切关注至关重要。本病例突出了提高警惕并制定针对性预防策略以降低TNF-α治疗风险的必要性。

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