[Tuberculosis and anti-TNFalpha therapy].

Tuberculosis incidence at the beginning of the third millennium is increasing, together with appearance of multi resistant (MDR-TB) and extremely resistant Mycobacterium tuberculosis (XDR-TB). Tumor necrosis factor (TNFalpha) increases macrophage phagocytic capacity for Mycobacterias, and is included in granuloma formation. Anti-TNFalpha therapy used in some diseases in the field of gastroenterology, rheumatology and dermatology increase tuberculosis incidence even 30 times in comparison with imunocompetent persons. Patient's screening before introduction of anti-TNFalpha therapy decreases manifest tuberculosis for 90%. Key finding in the screening process (according to the Guidelines shown in the paper) is family history or previously tuberculosis, tuberculin skin test (PPD), chest X-ray, in certain cases immunology diagnostic test for tuberculosis, while in infected persons sputum culture for tuberculosis is needed to ruled out manifest tuberculosis.