肿瘤坏死因子 (TNF)-α 抑制剂治疗强直性脊柱炎患者的播散性结核病:病例报告。

IF 1 Q3 MEDICINE, GENERAL & INTERNAL Cureus Pub Date : 2024-10-31 eCollection Date: 2024-10-01 DOI:10.7759/cureus.72796
Lana Fadl, Arowa Abdelgadir, Hibah Mirza, Aqsa Mahreen, Siddalingana Gouda Thaplar G Gouda
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引用次数: 0

摘要

由于肿瘤坏死因子-α(TNF-α)抑制剂能有效减轻炎症和延缓疾病进展,因此常用于治疗强直性脊柱炎(AS)。然而,使用这些药物会增加机会性感染的风险,尤其是结核病(TB)。本病例报告介绍了英国一名患有强直性脊柱炎的年轻男性患者,他曾长期使用 TNF-α 抑制剂阿达木单抗进行生物治疗。患者出现了播散性结核,病情迅速发展,不幸死亡。该病例强调了在开始TNF-α抑制剂治疗前对潜伏肺结核进行全面筛查以及在整个治疗过程中进行持续监测的重要性。考虑到英国的多元文化特性,个人可能在没有前往结核病流行地区的情况下也会接触到结核病,因此仔细关注所有种族的结核病风险至关重要。本病例强调了提高警惕和采取有针对性的预防策略以降低TNF-α治疗风险的必要性。
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Disseminated Tuberculosis in a Patient on Tumor Necrosis Factor (TNF)-α Inhibitor Treatment for Ankylosing Spondylitis: A Case Report.

Tumour necrosis factor-alpha (TNF-α) inhibitors are commonly used in the treatment of ankylosing spondylitis (AS) due to their effectiveness in reducing inflammation and slowing disease progression. However, their use is associated with an increased risk of opportunistic infections, particularly tuberculosis (TB). This case report presents a young male patient in the United Kingdom (UK) with AS, who had been on long-term biological therapy with adalimumab, a TNF-α inhibitor. The patient developed disseminated TB, which rapidly progressed and unfortunately resulted in the patient's death. This case underscores the importance of comprehensive screening for latent TB before initiating TNF-α inhibitor therapy, as well as ongoing monitoring throughout treatment. Given the multicultural nature of the UK, where individuals may be exposed to TB without traveling to endemic areas, careful attention to TB risk across all ethnicities is critical. This case highlights the need for heightened vigilance and tailored preventive strategies to mitigate the risks of TNF-α therapy.

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