ISSN: 1309 - 3843 E-ISSN: 1307 - 7384
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COVID-19 Pandemisinde TNF İnhibitörlerinin Unutulmaması Gereken Bir Yan Etkisi: Akciğer Tüberkülozu
A Side Effect of TNF Inhibitors That Should not be Forgotten in the COVID-19 Pandemic: Pulmonary Tuberculosis
Received Date : 16 Oct 2021
Accepted Date : 01 Jun 2022
Available Online : 08 Jun 2022
Doi: 10.31609/jpmrs.2021-86680 - Makale Dili: TR
J PMR Sci. 2022;25(3):386-9
ÖZET
Ankilozan spondilit (AS); primer olarak aksiyal iskeleti etkileyen, ayrıca periferik eklemlerde ve entezis bölgelerinde de inflamasyona neden kronik inflamatuar bir hastalıktır. Erkeklerde daha sık görülür ve prevalansı %0,5-1,6 arasında bildirilmektedir. Tümör nekrozis faktör alfa (TNF-ɑ), hastalığın etiyopatogenezinde önemli bir sitokindir ve TNF’yi bloke eden biyolojik tedaviler son yıllarda yaygın bir şekilde AS’li hastalarda kullanılmaktadır. Tüberküloz enfeksiyonları, anti-TNF’lerin önemli bir yan etkisidir. Monoklonal antikorlar olan adalimumab ve infliksimabta riskin daha yüksek olduğu rapor edilmektedir. Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] pandemisinde kronik hastalığı olan bireylerin hastanelere başvurularında ciddi azalma meydana gelmiştir. Bu da hastaların komplikasyonlarla hastaneye başvurma ihtimalini ortaya çıkarmaktadır. Bu olgu sunumunda, COVID-19 pandemisi sürecinde adalimumab tedavisi altında tüberküloz enfeksiyonu gelişen AS tanılı bir vakayı sunuyoruz.
ABSTRACT
Ankylosing spondylitis (AS) is a chronic inflammatory disease that primarily affects the axial skeleton and also causes inflammation in the peripheral joints and enthesis areas. It is more common in men and its prevalence is reported to be between 0.5 and 1.6%. Tumor necrosis factor alpha (TNF-ɑ) is an important cytokine in the etiopathogenesis of the disease, and biologic therapies that block TNF have been widely used in patients with AS in recent years. Tuberculosis infections are an important side effect of anti-TNFs. The risk is reported to be higher with the monoclonal antibodies adalimumab and infliximab. In the coronavirus disease-2019 (COVID-19) pandemic, there has been a serious decrease in the applications of individuals with chronic diseases to hospitals. This raises the possibility of patients presenting to the hospital with complications. In this case report, we present a case of AS who developed tuberculosis infection under adalimumab treatment during the COVID-19 pandemic.
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