The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Clinical characteristics and treatment responses of patients who developed tuberculosis following use of a tumor necrosis factor-${\alpha}$ inhibitor

  • Chung, Keun Bum (Divisions of Pulmonary and Critical Care Medicine, Seoul National University College of Medicine) ;
  • Lee, Eun Young (Divisions of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Im, Jong Pil (Division of Gastroenterology and Hepatology, Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) ;
  • Han, Sung Koo (Divisions of Pulmonary and Critical Care Medicine, Seoul National University College of Medicine) ;
  • Yim, Jae-Joon (Divisions of Pulmonary and Critical Care Medicine, Seoul National University College of Medicine)
  • Published : 2013.03.01
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Abstract

Background/Aims: Individuals being treated with tumor necrosis factor (TNF)-${\alpha}$ inhibitors are at increased risk of developing tuberculosis (TB). We determined the clinical characteristics and treatment response of patients who developed TB after using TNF-${\alpha}$ inhibitors. Methods: Patients with TB detected within 12 months of the initiation of TNF-${\alpha}$ inhibitor treatment were included, if seen from January 1, 2000 to August 31, 2011. We retrospectively reviewed the clinical records, results of bacteriological examinations, and radiographs of the included patients and the response to anti-TB treatment. Results: We indentified seven cases of TB in 457 patients treated with TNF-${\alpha}$ inhibitors during the study period. TB developed a median of 123 days (range, 48 to 331) after the first dose of TNF-${\alpha}$ inhibitor. Pulmonary TB, including TB pleuritis, was diagnosed in three patients and extrapulmonary TB in four. Favorable treatment outcomes were achieved in six of seven patients. Conclusions: Among the TNF-${\alpha}$ inhibitor users who contracted TB, extrapulmonary sites were common and the treatment response was satisfactory.

Keywords

References

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