Clinical Rheumatology

, Volume 29, Issue 10, pp 1201–1204 | Cite as

Cerebral tuberculoma in a patient receiving anti-TNF alpha (adalimumab) treatment

Case Report


We report a case of a cerebral tuberculoma in a 60-year-old woman with rheumatoid arthritis while receiving the anti-tumor necrosis factor alpha monoclonal antibody, adalimumab (Humira), for active disease. MR brain imaging for dyspraxia revealed a left parietal ring-enhancing lesion, which on resection was shown to be a necrotizing granuloma. There were no associated pulmonary lesions, and the patient was systemically well. Sputum and urine cultures were negative for tuberculosis. The patient was treated with anti-tuberculous medications and made an excellent recovery. We consider this to be the first documented case of tuberculosis involving the central nervous system occurring in the setting of adalimumab treatment.


Adalimumab Anti-TNF Cerebral Rheumatoid arthritis. Tuberculoma 



Centers for Disease Control


Tumor necrosis factor


Ziehl Nielson


Glial fibrillary acidic protein


Purified protein derivative


Rheumatoid arthritis


Disease-modifying anti-rheumatic drugs


Latent tuberculous bacilli infection


Interferon-gamma release assay.



The following case report is authored by Karen Lynch MD and Michael Farrell MD. It adheres to ethical guidelines and standards, and there was no financial or other conflict of interests associated with this case or the authors.


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Copyright information

© Clinical Rheumatology 2010

Authors and Affiliations

  1. 1.Department of NeuropathologyBeaumont HospitalDublin 9Ireland
  2. 2.Department of Neurology Tufts UniversitySt Elizabeth’s Medical CenterBostonUSA

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