Multidrug-resistant Disseminated Tuberculosis Related to Infliximab in a Patient with Ulcerative Colitis and Negative Evaluation for Latent Tuberculosis
전유경, 천재영, 강은애, 이현정, 임종필, 김주성,
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전유경 ( Jun Yu-Kyung )
Seoul National University College of Medicine Department of Internal Medicine
천재영 ( Chun Jae-Young )
Seoul National University College of Medicine Department of Internal Medicine
강은애 ( Kang Eun-Ae )
Seoul National University College of Medicine Department of Internal Medicine
이현정 ( Lee Hyun-Jung )
Seoul National University College of Medicine Department of Internal Medicine
임종필 ( Im Jong-Pil )
Seoul National University College of Medicine Department of Internal Medicine
김주성 ( Kim Joo-Sung )
Seoul National University College of Medicine Department of Internal Medicine
Abstract
Anti-tumor necrosis factor (anti-TNF) is an effective biological agent for the treatment of moderate-to-severe active ulcerative colitis (UC) refractory to conventional therapy. On the other hand, anti-TNF therapy is strongly associated with a potential risk of tuberculosis (TB). Active TB is a critical complication that makes it difficult to treat patients who require anti-TNF for the treatment of UC refractory to conventional therapy. Based on the clinical guidelines, patients with inflammatory bowel disease (IBD) are strongly recommended to screen for latent TB before anti-TNF administration. Considering the possibility of active or reactivated TB related to anti-TNF therapy, all patients with IBD should be monitored closely for TB during anti-TNF therapy, irrespective of the screening results for latent TB. In particular, the risk of anti-TNF-related multidrug-resistant TB (MDR-TB) in patients with IBD has not been elucidated. This paper reports the first case of disseminated MDR-TB that developed in a UC patient receiving infliximab despite the negative evaluation for latent TB screening.
키워드
Inflammatory bowel diseases; Infliximab; Tuberculosis, multidrug-resistant; Colitis, ulcerative
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