Tuberculosis-Related Uveitis in Patients under Anti-TNF-alpha Therapy: A Case Series

被引:4
作者
Hernanz, I [1 ]
Miguel Escuder, L. [1 ]
Chamorro, L. [1 ]
Moll-Udina, A. [1 ,2 ]
Espinosa, G. [1 ,2 ]
Sainz de la Maza, M. [1 ,2 ]
Llorenc, V [1 ,2 ]
Adan, A. [1 ,2 ]
机构
[1] Univ Barcelona, Hosp Clin Barcelona, Clin Inst Ophthalmol, Barcelona, Spain
[2] Biomed Res Inst August Pi I Sunyer IDIBAPS, Barcelona, Spain
关键词
Tuberculosis; uveitis; anti-TNF therapy; latent tuberculosis infection; adalimumab; infliximab; Behç et disease; spondyloarthropaties; ankylosing spondylitis; Crohn’ s disease; NONINFECTIOUS UVEITIS; ADALIMUMAB; PREVENTION; EFFICACY; SAFETY; RISK;
D O I
10.1080/09273948.2020.1834588
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Tumor necrosis factor inhibitors (anti-TNF) have emerged as an effective treatment in noninfectious uveitis (NIU). Anti-TNF may increase the predisposition to infectious disease as tuberculosis (TB). TB-related uveitis in the context of an uveitogenic concurrent systemic immune-mediated disease under anti-TNF treatment remain a diagnostic challenge, deserving special focus on this rare context. Retrospective chart review of patients on anti-TNF drugs for systemic immune-mediated diseases that developed a multicentric microbiologically confirmed active TB with concurrent intraocular involvement. Three patients were recorded. Screening for TB before starting anti-TNF resulted negative in two patients. The other patient had received anti-tuberculous treatment in the past. All showed a microbiologically confirmed extraocular TB after unexpected atypical reactivation of the uveitis shifting to chronic granulomatous pattern. Specialists should be aware of TB reactivation, even with previous negative screening, when ocular uveitis signs and activity do not match with the expected pattern in a patient on anti-TNF drugs.
引用
收藏
页码:839 / 844
页数:6
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