European journal of pediatrics · 2011
Life-threatening disseminated tuberculosis as a complication of TNF-α blockade in an adolescent.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Hess Steffen, Hospach Toni, Nossal Robert, Dannecker Günther, Magdorf Klaus, Uhlemann Frank
Аннотация
Life-threatening disseminated tuberculosis developed in a 17-year-old girl who was treated with the TNF-α blocker adalimumab for refractory SAPHO syndrome. The patient presented to the emergency department with dyspnea and somnolence and within 2 h developed the clinical picture of a septic shock. In addition to this unusual presentation, she showed a complicated course with increasing cerebral granuloma formation in spite of adequate antimycobacterial treatment. Immune reconstitution after discontinuation of TNF blockade may contribute to this "paradoxical reaction." Possible implications for screening, diagnosis, and treatment of tuberculosis in children and adolescents receiving anti-TNF treatment are discussed.
Предметные рубрики MeSH
Acquired Hyperostosis SyndromeAdalimumabAdolescentAnti-Inflammatory AgentsAntibodies, Monoclonal, HumanizedAntitubercular AgentsAza CompoundsDrug Therapy, CombinationDyspneaEthambutolFemaleFluoroquinolonesHumansImmunocompromised HostImmunosuppressive AgentsMoxifloxacinQuinolinesSeverity of Illness IndexShock, SepticTreatment OutcomeTuberculosis, MiliaryTumor Necrosis Factor-alpha