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Abstract
Case Report
A case of tuberculosis-associated immune reconstitution inflammatory syndrome for which early reintroduction of adalimumab and corticosteroid was effective
Yuki Fukushiroa,* Yusuke Takayamaa Shohei Mishimaa Ken Masudaa Hiroyasu Shodaa Yasuo Iwamotob
aDepartment of Respiratory Medicine, Hiroshima City Hiroshima Citizens Hospital
bDepartment of Oncology, Hiroshima City Hiroshima Citizens Hospital
*Present address: Department of Respiratory Medicine, Hiroshima Red Cross Hospital & Atomic-bomb Survivors Hospital
ABSTRACT
A 49-year-old female with hidradenitis suppurativa under treatment with the tumor necrosis factor (TNF) α antagonist adalimumab was admitted to our hospital with tuberculosis (TB). We initiated anti-TB therapy (rifampicin, isoniazid, pyrazinamide, and ethambutol) and discontinued adalimumab. One month later, she developed chylothorax due to immune reconstitution inflammatory syndrome (IRIS). After we started corticosteroid (prednisolone 1.0 mg/kg/day as the initial dose) and resumed adalimumab for TB-IRIS, there was no re-accumulation of chylothorax. Finally, she completed a 9-month course of anti-TB therapy, and prednisolone was tapered off over the course of 9 months. In this case, the re-administration of a TNF α inhibitor with corticosteroid treatment was safe and effective for the management of TB-I
KEYWORDS
Adalimumab Anti-tumor necrosis factor agent Tuberculosis (TB) Immune reconstitution inflammatory syndrome (IRIS) Chylothorax
Received 16 Jun 2022 ／ Accepted 22 Sep 2022
AJRS, 12(1): 29-33, 2023
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