Lungentuberkulose unter Therapie mit Tocilizumab/Etanercept

Zusammenfassung

In unserer Ambulanz wurde bei einer 82-jährigen Patientin nach Diagnose einer late onset seropositiven ACPA-negativen Rheumatoiden Arthritis (LORA) zunächst eine Therapie mit Leflunomid begonnen. Im Verlauf musste die Therapie auf Etanercept gewechselt werden. Bei positivem Quantiferontest erfolgte eine Chemoprävention mit Rifampicin. Im Verlauf präsentierte sich die Patientin mit der Diagnose einer Großgefäßvaskulitis, in der Rückschau lag also initial eine Polymyalgia rheumatica (PMR) vor. Die Therapie wurde auf Tocilizumab geändert und die Pat. erhielt einen Prednisolonstoß. Unter der Therapie mit Tocilizumab/Prednisolon entwickelte die Patientin eine polysensible Lungentuberkulose.

Abstract

In our outpatient clinic, an 82-year-old female patient was diagnosed with late-onset seropositive ACPA-negative rheumatoid arthritis (LORA) and was started on treatment with leflunomide. In the course of that treatment, the medication had to be changed to etanercept. The QuantiFERON test showed a positive result and chemoprevention with rifampicin was started. During that treatment, the patient presented with a diagnosis of large-vessel vasculitis, which means that, in retrospect, the initial condition had been polymyalgia rheumatica (PMR). The medication was changed to tocilizumab and the patient received a prednisolone shot. During the treatment with tocilizumab/prednisolone, the patient developed poly-sensitive pulmonary tuberculosis.

Schlüsselwörter

Tuberkulose - Tocilizumab - Etanercept

Key words

Tuberculosis - Tocilizumab - Etanercept

Publication History

Article published online:
04 October 2023

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