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Review Case Reports
Paradoxical exacerbation of tuberculosis after TNFα antagonist discontinuation: beware of immune reconstitution inflammatory syndrome.
- Claire Rivoisy, Lucile Amrouche, Guislaine Carcelain, Daniel Séréni, and Anne Bourgarit.
- Service de Médecine Interne, Université Paris 7, Hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
- Joint Bone Spine. 2011 May 1;78(3):312-5.
AbstractParadoxical worsening of tuberculosis associated with immune reconstitution during antiretroviral therapy in patients with HIV infection is known as the immune reconstitution inflammatory syndrome (IRIS). Here, we report a case of paradoxical worsening of IFN-alpha induced tuberculosis in a patient experiencing reconstitution of pathogen-specific immune responses after discontinuing TNFα antagonist therapy. This case serves to alert clinicians that complications such as tuberculosis may worsen after TNFα antagonist discontinuation. This situation may paradoxically require readministration of the immunosuppressive drug in some patients.Copyright © 2011 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.
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