Abstract
Tuberculosis infection (TB) is one of the most important problems for the rheumatoid arthritis (RA) patients treated with anti-TNF agents. Pulmonary tuberculosis is the most common clinic form of the TB in these patients. However, tuberculosis arthritis is very rare. We present here a 72-year-old Caucasian woman with seropositive RA, treated with etanercept/adalimumab for the last 2 years, who presented with resistant knee pain and joint effusion. We believe that this treatment caused the tuberculosis in this patient, which is the most worried complication. Interestingly, tuberculosis was in the knee joint at this time.
Similar content being viewed by others
References
Spector TD (1990) Rheumatoid arthritis. Rheum Dis Clin North Am 16:513
Brassard P, Kezouh A, Suissa S (2006) Antirheumatic drugs and the risk of tuberculosis. Clin Infect Dis 43:717
Askling J, Fored CM, Brandt L et al (2005) Risk, case characteristics of tuberculosis in rheumatoid arthritis associated with tumor necrosis factor antagonists in Sweden. Arthritis Rheum 52:1986
Centers for Disease Control, Prevention (CDC) (2004) Trends in tuberculosis–United States, 1998 to 2003. MMWR Morb Mortal Wkly Rep 53(10):209–214
Gardam MA, Keystone EC, Menzies R et al (2003) Anti-tumour necrosis factor agents, tuberculosis risk: mechanisms of action, clinical management. Lancet Infect Dis 3:148
Gomez-Reino JJ, Carmona L, Valverde VR et al (2003) Treatment of rheumatoid arthritis with tumor necrosis factor inhibitors may predispose to significant increase in tuberculosis risk: a multicenter active-surveillance report. Arthritis Rheum 48:2122
Carmona L, Gomez-Reino JJ, Rodriguez-Valverde V et al. (2005) Effectiveness of recommendations to prevent reactivation of latent tuberculosis infection in patients treated with tumor necrosis factor antagonists. Arthritis Rheum
Solovic I, Sester M, Gomez-Reino JJ, Rieder HL, Ehlers S, Milburn HJ, Kampmann B, Hellmich B, Groves R, Schreiber S, Wallis RS, Sotgiu G, Schölvinck EH, Goletti D, Zellweger JP, Diel R, Carmona L, Bartalesi F, Ravn P, Bossink A, Duarte R, Erkens C, Clark J, Migliori GB, Lange C (2010) The risk of tuberculosis related to tumour necrosis factor antagonist therapies: a TBNET consensus statement. Eur Respir J 36(5):1185–1206
American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines (2002) Guidelines for the management of rheumatoid arthritis 2002 update. Arthritis Rheum 46:328–346
British Society for Rheumatology. Guidelines for prescribing TNF-α blockers in adults with rheumatoid arthritis London: British society for rheumatology. http: www.rheumatology.org.uk
Furst DE, Keystone EC, Kirkham B et al (2008) Updated consensus statement on biological agents for the treatment of rheumatic diseases, 2008. Ann Rheum Dis 67(Suppl 3):iii2
Tam LS, Leung CC, Ying SK, Lee GK, Yim CW, Leung YY, Kun EW, Wong KK, Li EK (2010) Risk of tuberculosis in patients with rheumatoid arthritis in Hong Kong–the role of TNF blockers in an area of high tuberculosis burden. Clin Exp Rheumatol 28(5):679–685
Nestorov I (2005) Clinical pharmacokinetics of TNF antagonists: how do they differ? Semin Arthritis Rheum 34:12
Saliu OY, Sofer C, Stein DS et al (2006) Tumor-necrosis-factor blockers: differential effects on mycobacterial immunity. J Infect Dis 194:486
Choi SW, Ahn JJ, Hwang YT, Koh SH, Cho SD (2009) A case of tuberculous arthritis following the use of etanercept. Korean J Intern Med 24(4):397–401
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Nalbant, S., Özyurt, M., Yıldırım, M. et al. Pulmonary tuberculosis and tuberculous arthritis of knee joint associated with rheumatoid arthritis treated with anti-tumor necrosis factor (TNF)-alpha medication: a case report. Rheumatol Int 32, 2863–2866 (2012). https://doi.org/10.1007/s00296-011-2119-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-011-2119-0