잠복 결핵 검사에 음성 반응을 보인 궤양성 대장염 환자에서 발생한 Infliximab 연관 다제내성 파종성 결핵
Other Titles
Multidrug-resistant Disseminated Tuberculosis Related to Infliximab in a Patient with Ulcerative Colitis and Negative Evaluation for Latent Tuberculosis
Authors
전유경 ; 천재영 ; 강은애 ; 이현정 ; 임종필 ; 김주성
Citation
Korean Journal of Gastroenterology, Vol.74(3) : 168-174, 2019
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.