Abstract
Here, we report a 56-year-old patient with rheumatoid arthritis (RA) who had been treated with methotrexate and sulfuasalazine, but the disease activity remained high. Therefore, we planned TNF-blocker treatment for this patient. A tuberculin skin test was positive, we started anti-tuberculosis (TB) chemoprophylaxis with isoniazid (INH). However, liver dysfunction was appeared after 2 weeks from the start of INH. Therefore, we discontinued INH transiently and tried the desensitization of INH. However, interstitial pneumonia was developed 2 weeks after the re-start of INH, we decided to stop the INH prophylaxis. Interstitial pneumonia was improved by corticosteroid treatments. This case report shows that INH-induced IP can be occurred during the course of anti-TB chemoprophylaxis in patients with RA.
This is a preview of subscription content, log in via an institution to check access.
References
Carmona L, Gómez-Reino JJ, Rodríguez-Valverde V, Montero D, Pascual-Gómez E, Mola EM, Carreño L, Figueroa M, Group BIOBADASER (2005) Effectiveness of recommendations to prevent reactivation of latent tuberculosis infection in patients treated with tumor necrosis factor antagonists. Arthritis Rheum 52:1766–1772
Mor A, Bingham CO 3rd, Kishimoto M, Izmirly PM, Greenberg JD, Reddy S, Rosenthal PB (2008) Methotrexate combined with isoniazid treatment for latent tuberculosis is well tolerated in patients with rheumatoid arthritis: experience from an urban arthritis clinic. Ann Rheum Dis 67:462–465
Miyai M, Tsubota T, Asano K (1989) Isoniazid-induced interstitial pneumonia. Respir Med 83:517–519
Salomaa ER, Ruokonen EL, Tevola K, Tala E (1990) Pulmonary infiltrates and fever induced by isoniazid. Postgrad Med J 66:647–649
Gómez-Reino JJ, Carmona L, Valverde VR, Mola EM, Montero MD, BIOBADASER Group (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 48:2122–2127
Wolfe F, Michaud K, Anderson J, Urbansky K (2004) Tuberculosis infection in patients with rheumatoid arthritis and the effect of infliximab therapy. Arthritis Rheum 50:372–379
Takeuchi T, Tatsuki Y, Nogami Y, Ishiguro N, Tanaka Y, Yamanaka H, Kamatani N, Harigai M, Ryu J, Inoue K, Kondo H, Inokuma S, Ochi T, Koike T (2008) Postmarketing surveillance of the safety profile of infliximab in 5000 Japanese patients with rheumatoid arthritis. Ann Rheum Dis 67:189–194
Miyasaka N, Takeuchi T, Eguchi K (2005) Proposed [corrected] Japanese guidelines for the use of infliximab for rheumatoid arthritis. Mod Rheumatol 15:4–8
Anaya JM, Diethelm L, Ortiz LA, Gutierrez M, Citera G, Welsh RA, Espinoza LR (1995) Pulmonary involvement in rheumatoid arthritis. Semin Arthritis Rheum 24:242–254
Matsushima H, Sugita Y, Yanagisawa T, Ubukata M, Kurosawa T, Yoshida F, Kanazawa M (2003) A case of isoniazid sodium methanesulfonate induced interstitial pneumonia. Kekkaku 78:401–406
Nishizawa Y, Yasui M, Yamamori C, Tagami A, Fujimura M, Nakao S (2004) A case of successful desensitization therapy for isoniazid-induced pneumonitis. Nihon Kokyuki Gakkai Zasshi 42:649–654
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Migita, K., Umeno, T., Miyagawa, K. et al. Development of interstitial pneumonia in a patient with rheumatoid arthritis induced by isoniazid for tuberculosis chemoprophylaxis. Rheumatol Int 32, 1375–1377 (2012). https://doi.org/10.1007/s00296-010-1441-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-010-1441-2