Inappropriate prescription of corticosteroid therapy during inflammatory ileo‐colitis revealing disseminated tuberculosis with digestive involvement: Two case reports

Razafindrazoto, Chantelli Iamblaudiot; Randriamifidy, Nitah Harivony; Rakotomalala, Jolivet Auguste; Ralaizanaka, Behoavy Mahafaly; Rakotomaharo, Mialitiana; Laingonirina, Domoina Harivonjy Hasina; Maherison, Sonny; Rasolonjatovo, Anjaramalala Sitraka; Rakotozafindrabe, Andry Lalaina Rinà; Rabenjanahary, Tovo Harimanana; Razafimahefa, Soloniaina Hélio; Ramanampamonjy, Rado Manitrala

doi:10.1002/ccr3.4215

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…Clinical deterioration in ITB is often caused by immunosuppressive medications, such as anti-TNF and steroid therapy. With the introduction of anti-TNF agents, treatment outcomes for CD have improved; however, anti-TNF agents are known to increase the risk for serious infections, with a reported twofold to eightfold risk for developing active TB 9 10. Our patient was started on adalimumab, a humanised monoclonal antibody targeting TNF-α.…”

Section: Discussionmentioning

confidence: 96%

Crohn’s disease and intestinal tuberculosis: challenging from every angle

Guimarães,

Gama,

Curvo-Semedo

et al. 2023

BMJ Case Rep

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A woman in her 20s with a recent diagnosis of Crohn’s disease (CD) affecting the ileocaecal valve was started on adalimumab, after routine tuberculosis (TB) tests were negative. Her abdominal symptoms got worse and she started presenting respiratory distress and fever. Tomography revealed a left pleural effusion, pneumonia and peritonitis with pelvic abscess. The diagnosis of disseminated TB with digestive involvement was suggested and sputum cultures were positive forMycobacterium tuberculosis. Treatment for TB was started and immunosuppressants discontinued, leading to respiratory improvement. Abdominal imaging was repeated, showing worsening signs of multisegmental ileal wall thickening, ileocaecal valve obstruction and a persistent pelvic abscess. She was then submitted to a laparoscopic ileocaecal resection for suspicion of worsening CD. Histopathology showed chronic ileocolitis compatible with CD and ganglionic tuberculosis, revealing the diagnosis of intestinal tuberculosis superimposed in CD. Recovery was uneventful.

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Section: Discussionmentioning

confidence: 96%