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A Case of Multiple Tuberculosis Associated with Infliximab Therapy in Crohn's Disease

크론병 환자에서 Infliximab 치료 후 발생한 중증 다발성 결핵 1예

  • Kim, Hee-Wook (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Jang, Sung-Ill (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Bun (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Youn, Young-Hoon (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Byun, Min-Kwang (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Park, Hyo-Jin (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, Sang-In (Department of Internal Medicine, Yonsei University College of Medicine)
  • 김희욱 (연세대학교 의과대학 내과학교실) ;
  • 장성일 (연세대학교 의과대학 내과학교실) ;
  • 김번 (연세대학교 의과대학 내과학교실) ;
  • 윤영훈 (연세대학교 의과대학 내과학교실) ;
  • 변민광 (연세대학교 의과대학 내과학교실) ;
  • 박효진 (연세대학교 의과대학 내과학교실) ;
  • 이상인 (연세대학교 의과대학 내과학교실)
  • Published : 2012.09.01

Abstract

Infliximab, a tumor necrosis $factor-{\alpha}$($TNF-{\alpha}$) inhibitor, has been approved for the treatment of a variety of inflammatory illnesses, including Crohn's disease. However, infliximab can increase the risk of reactivation of latent tuberculosis (Tbc) infection by affecting host immune responses. Therefore, a screening test should be performed before the initiation of infliximab therapy, and patients with evidence of latent infection should be treated with prophylactic anti-Tbc therapy. Here, we report a case of multifocal disseminated tuberculosis after treatment with infliximab in a patient diagnosed with Crohn's disease who had no past history of Tbc and showed a negative screening test.

크론병이 스테로이드에 불응성이거나 의존적인 경우, 누공병변을 동반한 경우에 $TNF-{\alpha}$ 억제제인 infliximab이 효과적이나 결핵을 일으키는 부작용이 있다. 저자들은 결핵의 병력이 없고 선별검사상 음성인 크론병 환자에서 infliximab사용 후 다발성 중증 결핵이 합병된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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