A case of preventable pulmonary tuberculosis in a Greenlandic, heavily immune suppressed patient

• Published in: Respiratory Medicine Case Reports
• Main Authors: Christensen, Anne-Sophie H., Johansen, Isik S.
• Format: Text
• Language: English
• Published: Elsevier 2011
• Subjects: Case Report; greenlandic
• Online Access: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3920416; https://doi.org/10.1016/j.rmedc.2011.08.006

Immune modulating therapy, such as tumour necrosis factor (TNF)-alpha inhibitors, is becoming increasingly more widespread in the treatment of many autoimmune diseases. One of the well-documented side effects of TNF-alpha inhibitors is an increased risk of reactivating latent tuberculosis infection (LTBI). Diagnostic tools available for diagnosing LTBI lack sensitivity and specificity. We report the case of a rheumatoid arthritis (RA) patient at high-risk of reactivation of LTBI, who should have been offered prophylactic anti-tuberculous treatment on two separate occasions: firstly, before initiating anti-TNF-α treatment and secondly, as part of routine tuberculosis contact tracing. He subsequently developed severe pulmonary tuberculosis and was hospitalised for 6 weeks.