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Emilie Ziegler Faunø1, Jesper Winkler Andersen1, Thomas Møller Jensen1

  • 1Medicinsk Afdeling, Regionshospitalet Horsens.

Ugeskrift for Laeger
|March 31, 2023
PubMed
Summary
This summary is machine-generated.

Biological treatments can increase opportunistic infection risk. Even after preventive tuberculosis treatment, a Crohn's patient developed peritoneal tuberculosis, highlighting diagnostic challenges and relapse risks during anti-TNF-inhibitor therapy.

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Area of Science:

  • Immunology
  • Gastroenterology
  • Infectious Diseases

Background:

  • Biological therapies, particularly anti-tumor necrosis factor (TNF)-inhibitor agents, are associated with an increased risk of opportunistic infections.
  • Current guidelines mandate tuberculosis (TB) screening before initiating such treatments.
  • Prophylactic TB eradication is often employed to mitigate this risk.

Observation:

  • This case report details a patient with Crohn's disease who developed peritoneal tuberculosis.
  • The patient had previously completed a preventive TB eradication regimen.
  • Symptoms included ascites, necessitating extensive diagnostic workup.

Findings:

  • A peritoneal biopsy ultimately confirmed the diagnosis of tuberculosis.
  • This case illustrates that even with prior TB eradication, relapse can occur during anti-TNF-inhibitor therapy.

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  • Diagnosing TB, especially in extrapulmonary sites like the peritoneum, can be challenging.

    • Implications:

    • Preventive TB treatment does not eliminate the risk of relapse during immunosuppressive therapy.
    • Vigilance for opportunistic infections, including tuberculosis, is crucial in patients receiving biological treatments.
    • This highlights the need for ongoing research into optimal screening and management strategies for TB in immunocompromised patients.