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Chest clinic
Case based discussions
Tuberculosis during TNF-α inhibitor therapy, despite screening
  1. Regina W Hofland1,
  2. Steven F T Thijsen2,
  3. Marc A M T Verhagen3,
  4. Yolande Schenk4,
  5. Ailko W J Bossink1
  1. 1Department of Pulmonology and Tuberculosis, Diakonessenhuis Utrecht, Utrecht, The Netherlands
  2. 2Department of Medical Microbiology and Immunology, Diakonessenhuis Utrecht, Utrecht, The Netherlands
  3. 3Department of Gastroenterology, Diakonessenhuis Utrecht, Utrecht, The Netherlands
  4. 4Department of Rheumatology, Diakonessenhuis Utrecht, Utrecht, The Netherlands
  1. Correspondence to Dr Regina W Hofland, Department of Pulmonology and Tuberculosis, Diakonessenhuis Utrecht, Bosboomstraat 1, Utrecht 3582 KE, The Netherlands; reginahofland{at}hotmail.com

Abstract

As part of a prospective study on the safety of TNF-α inhibitor therapy after screening for and treatment of latent tuberculosis infection (LTBI), we report two patients who developed active tuberculosis (TB) infection during TNF-α inhibitor therapy, despite negative screening for LTBI. The clinical history is suggestive of a primary infection acquired during travelling to TB-endemic countries. In this lesson of the month we would like to highlight the risk of travelling to TB-endemic areas in patients treated with TNF-α inhibitor therapy.

Screening for latent tuberculosis infection is not enough to prevent tuberculosis in patients treated with TNF-α inhibitor therapy

  • Tuberculosis
  • Immunodeficiency
  • Respiratory Infection
  • Infection Control

https://doi.org/10.1136/thoraxjnl-2012-202974

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