Tuberculosis associated with tumor necrosis factor-α antagonists, case description and analysis of reported cases in Colombia

• Published in: Biomédica
• Main Authors: Leandro Galvis, Ángel Y. Sánchez, Leonardo F. Jurado, Martha I. Murcia
• Format: Article in Journal/Newspaper
• Language: English; Spanish
• Published: Instituto Nacional de Salud 2018
• Subjects: Mycobacterium tuberculosis; tuberculosis; latent tuberculosis; Cronh’s disease; diagnosis; risk factor; tumor necrosis factor-alpha; Colombia; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.7705/biomedica.v38i0.3273; https://doaj.org/article/2476996fa15c4f2ab6ca6bed8d7dc8b5

Tumor necrosis factor-α (TNF-α) is an important fundamental cytokine during the immune response against cancer and infections such as tuberculosis. This molecule also plays a key pathogenic role in complex and difficult-to-treat diseases such as rheumatoid arthritis, ankylosing spondylitis, Crohn’s disease, psoriasis and ulcerative colitis. The treatment of these diseases frequently needs TNF-α antagonists, which has been related to an increased risk of developing tuberculosis, mycoses, and other severe infections. We report the case of a 68-year-old man with Crohn’s disease, who developed disseminated tuberculosis due to anti-TNF-α immunosuppressive therapy. The diagnosis was based on the histopathological findings and molecular biology assays. We discuss the clinical presentation and workup of this case, and we present a comparative analysis of tuberculosis cases associated with anti-TNF-α reported in Colombia during the last 10 years emphasizing on the diagnosis and treatment of latent tuberculosis.