A case of lung tuberculosis in a patient with rheumatoid arthritis treated with infliximab after antituberculosis chemoprophylaxis with isoniazid

Abstract

We report a case of a 65-year-old man with rheumatoid arthritis. The patient was treated with methotrexate and prednisolone, but the disease activity remained high. A tuberculin skin test was positive. After antituberculosis (TB) chemoprophylaxis with isoniazid for four weeks, infliximab was administered. Chemoprophylaxis was continued for nine months. Active lung TB was diagnosed at 17 months after the cessation of isoniazid, namely at 27 months after starting infliximab treatment. This case report shows that TB can manifest after chemoprophylaxis in patients treated with antitumor necrosis factor agents.

Keywords::

• Chemoprophylaxis
• Infliximab
• Isoniazid
• Lung tuberculosis
• Rheumatoid arthritis