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Clinical cases of pulmonary tuberculosis as a result of TNF antagonist therapy

Valentina Dimitrova, M. Peneva, Yordan Radkov, Diana Petkova, A. Atanasova


During the past 12 years TNF antagonists have been successfully used for the treatment of many patients suffering from chronic inflammatory diseases. This treatment increases the risk of tuberculosis up to 25 times. This is due to the fact that TNF and TNF-receptors play an important role in mediating the immune response in acute and chronic inflammation. Therefore all patients undergoing such treatment should be subject to rigorous assessment to exclude active and latent tuberculosis infection. In 2010 a TBNET consensus was published entitled "The risk of tuberculosis related to TNF therapies." In this article we present two cases of pulmonary tuberculosis, which were observed in the course of an ongoing treatment with TNF antagonists in patients with proven inflammatory bowel disease.


tuberculosis, LTBI, TNF antagonists, TBnet, tuberculin skin test, IGRA test

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