Modern Rheumatology

, Volume 23, Issue 5, pp 1013–1017 | Cite as

Tuberculous pleurisy diagnosed by medical thoracoscopy in an adalimumab-treated rheumatoid arthritis patient after treatment of latent tuberculosis infection

  • Yasuo Nagafuchi
  • Hirofumi ShodaEmail author
  • Keishi Fujio
  • Satoru Ishii
  • Haruhito Sugiyama
  • Kazuhiko Yamamoto
Case Report


A 28-year-old rheumatoid arthritis woman treated with adalimumab was admitted with fever, cough, and right chest pain. X-ray showed right pleural effusion. By medical thoracoscopy, diffuse white nodules were observed, and biopsy specimen demonstrated epithelioid cell granulomas with necrosis and auramine-stained organisms, which suggested a diagnosis of tuberculous pleurisy. Medical thoracoscopy can be a potent diagnostic method when tuberculous pleurisy is suspected. Notably, despite latent tuberculosis treatment, active tuberculosis was not prevented.


Adalimumab Latent tuberculosis Pleural tuberculosis Rheumatoid arthritis Thoracoscopy 


Conflict of interest


Supplementary material

Supplementary material 1 (WMV 21825 kb)


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Copyright information

© Japan College of Rheumatology 2012

Authors and Affiliations

  • Yasuo Nagafuchi
    • 1
  • Hirofumi Shoda
    • 1
    Email author
  • Keishi Fujio
    • 1
  • Satoru Ishii
    • 2
  • Haruhito Sugiyama
    • 2
  • Kazuhiko Yamamoto
    • 1
  1. 1.Department of Allergy and Rheumatology, Graduate School of MedicineThe University of TokyoTokyoJapan
  2. 2.Department of Respiratory MedicineNational Center for Global Health and MedicineTokyoJapan

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