Intestinal tuberculosis in a patient on infliximab treatment

Karagiannis, Stephanos; Papaioannou, Dimitrios; Goulas, Spyros; Psilopoulos, Dimitrios; Mavrogiannis, Christos

doi:10.1016/j.gie.2007.12.048

Cited by 7 publications

(4 citation statements)

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“…30 The resurgence of TB in many developed countries has been attributed to higher migrating population, deteriorating social conditions, cutbacks in public health services and increasing prevalence of immuno suppressed/HIV-positive individuals. 3, 4, 5, 6, 7, 8, 9 In the United States, this escalation peaked in 1992 and since then there has been a steady decline, with TB now being diagnosed mostly in the migrant population. 8, 9 …”

Section: Discussionmentioning

confidence: 99%

“…2 There has also been a resurgence of TB in many developed countries secondary to migrant population, deteriorating social conditions, cutbacks in public health services and increasing prevalence of immuno-suppressed individuals. 3, 4, 5, 6, 7, 8, 9 In one study, coinfection of TB and HIV was reported to be as high as 73%. 6 TB is also a major concern in those receiving biological agents for conditions like rheumatoid arthritis or inflammatory bowel disease.…”

Section: Introductionmentioning

confidence: 99%

“…6 TB is also a major concern in those receiving biological agents for conditions like rheumatoid arthritis or inflammatory bowel disease. 3, 10 Immuno-suppressants given on the mistaken diagnosis of inflammatory bowel disease can result in systemic spread of TB with fatal consequences.…”

Section: Introductionmentioning

confidence: 99%

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Colon Tuberculosis: Endoscopic Features and Prospective Endoscopic Follow-Up After Anti-Tuberculosis Treatment

Mukewar

Ravi

et al. 2012

Clinical and Translational Gastroenterology

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OBJECTIVES:Tuberculosis (TB) is still common in many countries and there has been a resurgence of TB in the developed nations. Although small bowel is the most commonly affected gastrointestinal organ, increasing numbers of cases are being described with colon TB. There are limited prospective studies looking at the outcomes of colon lesions, especially after anti-TB treatment. Our aim was to evaluate the endoscopic features of TB of the colon and to prospectively follow up the endoscopic response of colon lesions to anti-TB treatment.METHODS:From October 2004 to December 2010 consecutive patients presenting with colon TB to one tertiary care center in India were enrolled. Demographic, clinical data, and lesions identified on colonoscopy were recorded. Anti-TB treatment was started and follow-up colonoscopy was performed within 4 weeks after completion of anti-TB treatment. Post-treatment endoscopic features and clinical outcomes were noted.RESULTS:Sixty-nine consecutive patients with colon TB were enrolled (mean age 39.3±14.8 years; male 45, female 24). Presenting clinical features included abdominal pain 80.6%, weight loss 74.6%, fever 40.3%, diarrhea/constipation 25.4%, diarrhea 16.4%, blood per rectum 11.9%, abdominal tenderness 37.3%, abdominal mass 13.4%, and lymphadenopathy 1.5%. Macroscopic lesions on endoscopy were predominantly right-sided (cecum and ascending colon) and primarily ulcers (ulcers 88.0%, nodules 50.7%, luminal narrowing 44.8%, polypoid lesion 10.4%). Majority of the ulcers (87.2%), nodules (84.6%), polypoid lesions (85.7%), luminal narrowing (76.2%), and ileo-cecal valve deformities (76.5%) resolved with anti-TB treatment.CONCLUSIONS:TB of the colon predominantly affects the cecum and the ascending colon. Ulceration, nodularity, and stricture are the prominent endoscopic findings. Majority of the lesions heal with anti-TB treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Colon Tuberculosis: Endoscopic Features and Prospective Endoscopic Follow-Up After Anti-Tuberculosis Treatment

Mukewar

Ravi

et al. 2012

Clinical and Translational Gastroenterology

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“…Karagiannis et al reported a case of intestinal TB in an patient with rheumatoid arthritis who was on infliximab treatment. [18] Intestinal TB presents a diagnostic challenge, given its non-specific clinical presentation and tendency to mimic other abdominal pathologies, such as inflammatory bowel disease and malignancy. [19,20]…”

Section: Discussionmentioning

confidence: 99%

Ulcerative intestinal tuberculosis case as a complication of treatment by infliximab for intestinal Behçet's disease

Yan

Yang

et al. 2019

Medicine

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Rationale:Intestinal Behçet's disease (BD) is characterized by intestinal ulcerations and gastrointestinal symptoms. Ulcerative intestinal tuberculosis (TB) is usually with dyspepsia, abdominal pain, vomiting, and weight loss. The 2 diseases exhibit similar clinical manifestations, but the most critical aspects of their clinical courses and required treatments are not at all similar.Patient concerns:We present a case in which a patient with intestinal Behçet's disease developed a de novo ulcerative intestinal TB infection after the start of anti-tumor necrosis factor-α treatment. This was despite histopathologic examination without caseous necrosis granuloma and negative for acid-fast staining and latent TB screen.Diagnoses:Intestinal Behçet's disease and intestinal TB.Interventions:The patient was treated with quadruple antituberculous chemotherapy, comprising rifapentine, isoniazid, ethambutol, and pyrazinamide.Outcomes:At follow-up about 3 months, the therapy of oral antituberculous drugs and thalidomide was continued and the patient's condition had stabilized.Lessons:This case illustrates the importance of closely monitoring patients who are on infliximab for possible onset of TB, even without abdominal symptoms, and with negative screening results for latent TB.

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Gastrointestinal Tuberculosis

Miagkova¹

2021

Tuberculosis and Nontuberculous Mycobacterial Infections

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Intestinal tuberculosis in a patient on infliximab treatment

Cited by 7 publications

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Colon Tuberculosis: Endoscopic Features and Prospective Endoscopic Follow-Up After Anti-Tuberculosis Treatment

Colon Tuberculosis: Endoscopic Features and Prospective Endoscopic Follow-Up After Anti-Tuberculosis Treatment

Ulcerative intestinal tuberculosis case as a complication of treatment by infliximab for intestinal Behçet's disease

Gastrointestinal Tuberculosis

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