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  • Title: [A case of pulmonary tuberculosis and tuberculous pleuritis during treatment with etanercept for rheumatoid arthritis].
    Author: Taniguchi H, Inomata M, Abo H, Izumi S.
    Journal: Nihon Kokyuki Gakkai Zasshi; 2009 Feb; 47(2):175-9. PubMed ID: 19260544.
    Abstract:
    A 64-year-old woman, afflicted with rheumatoid arthritis, consulted our hospital because of her clinical deterioration. Her doctor started treating her with etanercept and prednisolone 10 mg/day but without preventive chemotherapy for tuberculosis, because her chest CT showed only mild interstitial pneumonia, and her tuberculin test showed a slightly-positive reaction. Her symptoms improved, but her chest X-ray showed infiltration after two and a half months treatment, and right pleural effusion after four and a half months treatment. A diagnosis of pulmonary tuberculosis and tuberculous pleuritis was made because of an increase of adenosine deaminase in pleural effusion. She was treated with isoniazid, rifampicin, and ethambutol, resulting in a successful clinical course. Her sputum culture was positive, and a nucleic-acid amplification of Mycobacterium tuberculosis complex was positive. When prescribing etanercept, we should pay close attention to the possibility of tuberculosis.
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