A fatal case of tuberculous meningitis in a child with juvenile idiopathic arthritis: a diagnostic challenge

被引：5
作者：
Bal, Zumrut Sahbudak [1 ]
Yazici, Pinar [1 ]
Sen, Semra [1 ]
Eraslan, Cenk [2 ]
Cavusoglu, Cengiz [3 ]
Karapinar, Bulent [1 ]
Vardar, Fadil [1 ]
机构：
[1] Ege Univ, Dept Pediat, Med Sch, Izmir, Turkey
[2] Ege Univ, Dept Radiol, Med Sch, Izmir, Turkey
[3] Ege Univ, Dept Microbiol & Clin Microbiol, Med Sch, Izmir, Turkey
来源：
REVISTA DA SOCIEDADE BRASILEIRA DE MEDICINA TROPICAL | 2017年 / 50卷 / 05期
关键词：
Tuberculosis; Tumor necrosis factor antagonist; Juvenile idiopathic arthritis; RHEUMATOID-ARTHRITIS; RISK; THERAPY;
D O I：
10.1590/0037-8682-0410-2016
中图分类号：
R38 [医学寄生虫学]; Q [生物科学];
学科分类号：
07 ; 0710 ; 09 ; 100103 ;
摘要：
The prognosis of tuberculous meningitis, a rare form of extrapulmonary tuberculosis, depends on the stage of treatment initiation. We report a fatal case of tuberculous meningitis. The patient had received successive tumor necrosis factor (TNF) antagonists and abatacept to treat juvenile idiopathic arthritis, with negative results for polymerase chain reaction and acid-fast bacilli on smear, had normal cerebrospinal fluid (CSF) adenosine deaminase and glucose levels. Six weeks post-admission, the CSF culture demonstrated Mycobacterium tuberculosis. The altered immunological responses caused by anti-TNF treatment made the diagnosis challenging. Clinicians should bear this in mind and, if suspected, treatment should be initiated immediately.
引用
收藏
页码：709 / 711
页数：3
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共 12 条
  • [1] Tuberculosis Risk in Patients Treated with Non-Anti-Tumor Necrosis Factor-α (TNF-α) Targeted Biologics and Recently Licensed TNF-α Inhibitors: Data from Clinical Trials and National Registries
    Cantini, Fabrizio
    Niccoli, Laura
    Goletti, Delia
    [J]. JOURNAL OF RHEUMATOLOGY, 2014, 41 : 56 - 64
  • [2] The conversion rate of tuberculosis screening tests during biological therapies in patients with rheumatoid arthritis
    Cuomo, Giovanna
    D'Abrsca, Virginia
    Iacono, Daniela
    Pantano, Ilenia
    [J]. CLINICAL RHEUMATOLOGY, 2017, 36 (02) : 457 - 461
  • [3] Drug-specific risk of tuberculosis in patients with rheumatoid arthritis treated with anti-TNF therapy: results from the British Society for Rheumatology Biologics Register (BSRBR)
    Dixon, W. G.
    Hyrich, K. L.
    Watson, K. D.
    Lunt, M.
    Galloway, J.
    Ustianowski, A.
    Symmons, D. P. M.
    [J]. ANNALS OF THE RHEUMATIC DISEASES, 2010, 69 (03) : 522 - 528
  • [4] Risk Factors for Central Nervous System Tuberculosis
    Duque-Silva, Alexandra
    Robsky, Katherine
    Flood, Jennifer
    Barry, Pennan M.
    [J]. PEDIATRICS, 2015, 136 (05) : E1276 - E1284
  • [5] Anti-tumour necrosis factor agents and tuberculosis risk: mechanisms of action and clinical management
    Gardam, MA
    Keystone, EC
    Menzies, R
    Manners, S
    Skamene, E
    Long, R
    Vinh, DC
    [J]. LANCET INFECTIOUS DISEASES, 2003, 3 (03) : 148 - 155
  • [6] Effects of abatacept in patients with methotrexate-resistant active rheumatoid arthritis - A randomized trial
    Kremer, Joel M.
    Genant, Harry K.
    Moreland, Larry W.
    Russell, Anthony S.
    Emery, Paul
    Abud-Mendoza, Carlos
    Szechinski, Jacek
    Li, Tracy
    Ge, Zhiyu
    Becker, Jean-Claude
    Westhovens, Rene
    [J]. ANNALS OF INTERNAL MEDICINE, 2006, 144 (12) : 865 - 876
  • [7] Adverse effects of biologics: a network meta-analysis and Cochrane overview
    Singh, J. A.
    Wells, G. A.
    Christensen, R.
    Ghogomu, Tanjong E.
    Maxwell, L.
    MacDonald, J. K.
    Filippini, G.
    Skoetz, N.
    Francis, D.
    Lopes, L. C.
    Guyatt, G. H.
    Schmitt, J.
    La Mantia, L.
    Weberschock, T.
    Roos, J. F.
    Siebert, H.
    Hershan, S.
    Lunn, M. P. T.
    Tugwell, P.
    Buchbinder, R.
    [J]. COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2011, (02):
  • [8] Infections in Children and Adolescents With Juvenile Idiopathic Arthritis and Inflammatory Bowel Disease Treated With Tumor Necrosis Factor-α Inhibitors: Systematic Review of the Literature
    Toussi, Sima S.
    Pan, Nancy
    Walters, Heather M.
    Walsh, Thomas J.
    [J]. CLINICAL INFECTIOUS DISEASES, 2013, 57 (09) : 1318 - 1330
  • [9] Risk of Tuberculosis Is Higher With Anti-Tumor Necrosis Factor Monoclonal Antibody Therapy Than With Soluble Tumor Necrosis Factor Receptor Therapy The Three-Year Prospective French Research Axed on Tolerance of Biotherapies Registry
    Tubach, F.
    Salmon, D.
    Ravaud, P.
    Allanore, Y.
    Goupille, P.
    Breban, M.
    Pallot-Prades, B.
    Pouplin, S.
    Sacchi, A.
    Chichemanian, R. M.
    Bretagne, S.
    Emilie, D.
    Lemann, M.
    Lorthololary, O.
    Mariette, X.
    [J]. ARTHRITIS AND RHEUMATISM, 2009, 60 (07): : 1884 - 1894
  • [10] Tumour necrosis factor antagonists: structure, function, and tuberculosis risks
    Walls, Robert S.
    [J]. LANCET INFECTIOUS DISEASES, 2008, 8 (10) : 601 - 611
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