Tubercular Pleural Effusion in a Patient of Ulcerative Colitis Treated With Tofacitinib

Mishra, Shubhra; Singh, Anupam; Kopp, Chirag Rajkumar; Jena, Anuraag; Sharma, Vishal

doi:10.1093/ibd/izab234

Cited by 7 publications

(5 citation statements)

References 4 publications

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“…7 Ironically, there was only one case report of reactivation in UC following tofacitinib. 8 We would like to congratulate the authors on their meta-analysis, which supports the findings of the OCTAVE clinical trials and shows that tofacitinib is safe and effective in treating moderate-to-severe UC. We agree with the author that additional long-term studies of tofacitinib use in UC are required to more precisely define the maintenance of efficacy and to identify any late emerging safety signals.…”

supporting

confidence: 64%

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Tofacitinib in Ulcerative Colitis-evolving Efficacy and Safety

Tiwari

Ashraf

Bharali

2023

Journal of Clinical Gastroenterology

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supporting

confidence: 64%

“…Rifampicin prophylaxis, according to some research, may reduce tofacitinib’s effectiveness and cause an early termination 7. Ironically, there was only one case report of reactivation in UC following tofacitinib 8…”

mentioning

confidence: 99%

Tofacitinib in Ulcerative Colitis-evolving Efficacy and Safety

Tiwari

Ashraf

Bharali

2023

Journal of Clinical Gastroenterology

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“…Previous reports of TB in patients on tofacitinib in UC have described either tubercular lymphadenopathy or tubercular pleural effusion. 8,9 The clinical manifestations of miliary tuberculosis are protean and can be obscured till late in the disease course. Patients with miliary tuberculosis typically present with fever, night sweats, malaise, anorexia, and weight loss.…”

Section: Discussionmentioning

confidence: 99%

“…5 Although cases of tuberculosis (TB) have been reported in patients receiving tofacitinib for rheumatoid arthritis, limited data are available in patients with UC. 8,9 We report the case of a 43-year-old man, residing in a TB-endemic region (India), who developed miliary TB on tofacitinib prescribed for moderately severe active UC. The CARE recommendations for reporting case reports were adhered to while presenting this case report (see Supplement 1, Supplementary Digital Content 1, http://links.lww.com/ ACGCR/A35).…”

Section: Introductionmentioning

confidence: 99%

Miliary Tuberculosis in a Patient With Ulcerative Colitis Treated With Tofacitinib

Verma¹,

Singh²,

Kakkar³

et al. 2023

ACG Case Rep J

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Immunosuppression with tumor necrosis factor-alpha inhibitors and tofacitinib is a risk factor for reactivation of latent tuberculosis (TB) and the development of active TB. We report a case of miliary TB in a patient on treatment with tofacitinib for active ulcerative colitis. By week 4 of therapy, a clinical response was achieved. Subsequently, although being on treatment, the patient started having fever with night sweats and myalgias. The investigative workup revealed pulmonary miliary TB. Tofacitinib was withdrawn, and antitubercular therapy was initiated. The patient responded, both clinically and radiologically, to the antitubercular therapy. This case report highlights the importance of screening for latent TB in patients receiving tofacitinib.

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“…Although there are reports of conservative management having been successful [ 47 ], surgical management is the gold-standard treatment because it is usually effective. Finally, tumour necrosis factor α antagonists generally used for the treatment of inflammatory bowel disease may cause tuberculous PE [ 50 ].…”

Section: Intestinal Diseasesmentioning

confidence: 99%

Pleural effusion due to nonmalignant gastrointestinal disease

et al. 2022

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Although pleural effusion is a frequent finding in clinical practice, determining its etiology may be challenging, and up to 20% of cases remain undiagnosed. Pleural effusion may occur secondary to a non-malignant gastrointestinal disease. A gastrointestinal origin is confirmed based on a review of the medical history of the patient, and thorough physical examination and abdominal ultrasonography. In this process, it is crucial to correctly interpret findings on pleural fluid obtained by thoracentesis. In the absence of high clinical suspicion, identifying the etiology of this type of effusion may be difficult. Clinical symptoms will be determined by the gastrointestinal process causing PE. In this setting, correct diagnosis relies on the specialist's ability to associate pleural fluid appearance, test for the appropriate biochemical parameters, and determine whether it is necessary or not to send a specimen for culture. The established diagnosis will determine how pleural effusion is approached. Although this clinical condition is self-limited, many cases will require a multidisciplinary approach, as some effusions only resolved with specific therapies.

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Tubercular Pleural Effusion in a Patient of Ulcerative Colitis Treated With Tofacitinib

Cited by 7 publications

References 4 publications

Tofacitinib in Ulcerative Colitis-evolving Efficacy and Safety

Tofacitinib in Ulcerative Colitis-evolving Efficacy and Safety

Miliary Tuberculosis in a Patient With Ulcerative Colitis Treated With Tofacitinib

Pleural effusion due to nonmalignant gastrointestinal disease

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