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Kinder- und Jugendmedizin 2022; 22(04): 223-230
DOI: 10.1055/a-1854-1093
Schwerpunkt

Tuberkulose bei Kindern und Jugendlichen unter Therapie mit TNF-α-Inhibitoren

Tuberculosis in children and adolescents treated with anti-TNF-α inhibitors
Cornelia Feiterna-Sperling
1   Charité, Universitätsmedizin Berlin, Klinik für Pädiatrie m. S. Pneumologie und Immunologie, Berlin
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ZUSAMMENFASSUNG

Aufgrund des erhöhten Risikos einer Tuberkulose beim Einsatz von Tumor-Nekrose-Faktor (TNF)-α-Inhibitoren in der Therapie der juvenilen idiopathischen Arthritis und anderer chronisch-entzündlicher Erkrankungen soll bei allen Kindern und Jugendlichen vor Beginn einer Therapie mit TNF-α-Inhibitoren eine Tuberkulose ausgeschlossen werden und ein Screening auf das Vorliegen einer latenten tuberkulösen Infektion erfolgen. Das Screening beinhaltet eine sorgfältige Anamnese, die Durchführung eines Interferon-Gamma-Release-Assays und/oder Tuberkulin-Hauttests sowie eine Röntgen-Thorax-Aufnahme bei einem positiven Testresultat und/oder klinischem Hinweis auf eine Tuberkulose. Eine präventive Therapie der latenten tuberkulösen Infektion soll mit Isoniazid und Rifampicin über 3 Monate oder alternativ mit Isoniazid für 9 Monate durchgeführt werden.

ABSTRACT

Due to the increased risk of tuberculosis under treatment with tumor necrosis factor (TNF)-α inhibitors for juvenile idiopathic arthritis and other chronic inflammatory diseases, precautionary measures are required before initiating TNF-α inhibitor therapy. Children and adolescents should have tuberculosis ruled out and screening for latent tuberculosis infection should be performed. Screening for latent tuberculosis infection should include a complete medical history, the administration of an Interferon-γ-Release Assay and/or tuberculin skin test. A chest X-ray should be performed in all patients with positive test results and/or clinical signs of tuberculosis disease. For preventive treatment of latent tuberculosis infection, the combination of isoniazid and rifampicin given for 3 or isoniazid alone for 9 months is recommended.

Schlüsselwörter

Tuberkulose - Mycobacterium tuberculosis - latente tuberkulöse Infektion - Tumor-Nekrose-Faktor-α-Inhibitor

Keywords

Tuberculosis - mycobacterium tuberculosis - latent tuberculosis infection - anti-tumor necrosis factor-α inhibitor


Publikationsverlauf

Artikel online veröffentlicht:
17. August 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag KG,
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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