Tuberculous Peritonitis Mimicking Malignancy during Adalimumab Therapy in a Patient with Rheumatoid Arthritis

Abstract

We present a case of tuberculous peritonitis in a 46-year-old woman with rheumatoid arthritis treated with adalimumab, and we review the association between anti-tumour necrosis factor therapy and tuberculosis. This case illustrates that tuberculosis can develop with atypical clinic and uncertain laboratory findings and may mimic malignancies during adalimumab therapy.

Share and Cite:

Demirtunç, R. , Özensoy, U. , Kayataş, K. and Aker, F. (2015) Tuberculous Peritonitis Mimicking Malignancy during Adalimumab Therapy in a Patient with Rheumatoid Arthritis. Journal of Tuberculosis Research, 3, 72-76. doi: 10.4236/jtr.2015.33011.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Toussirot, E., Streit, G. and Wendling, D. (2007) Infectious Complications with Anti-TNFalpha Therapy in Rheumatic Diseases: A Review. Recent Patents on Inflammation & Allergy Drug Discovery, 1, 39-47.
http://dx.doi.org/10.2174/187221307779815039
[2] Olsen, N.J., Michael Stein, C. and Ch.B., M.B. (2004) New Drugs for Rheumatoid Arthritis. New England Journal of Medicine, 350, 2167-2179. http://dx.doi.org/10.1056/NEJMra032906
[3] Antolín, J., Azahara, M., Hernández, C., Blanco, M., Mao, L. and Cigüenza, R. (2008) Scand Tuberculous Peritonitis after Treatment with Adalimumab. Journal of Infectious Diseases, 40, 677-678.
[4] Yoo, I.K., Choung, R.S., Hyun, J.J., Kim, S.Y., Jung, S.W., Koo, J.S., et al. (2014) Incidences of Serious Infections and Tuberculosis among Patients. Yonsei Medical Journal, 55, 442-448.
http://dx.doi.org/10.3349/ymj.2014.55.2.442
[5] Saunders, B.M., Briscoe, H. and Britton, W.J. (2004) T Cell-Derived Tumour Necrosis Factor Is Essential, but Not Sufficient, for Protection against Mycobacterium tuberculosis Infection. Clinical & Experimental Immunology, 137, 279-287. http://dx.doi.org/10.1111/j.1365-2249.2004.02518.x
[6] Flynn, J.L., Goldstein, M.M., Chan, J., Triebold, K.J., Pfeffer, K., Lowenstein, C.J., et al. (1995) Tumor Necrosis Factor-Alpha Is Required in the Protective Immune Response against Mycobacterium tuberculosis in Mice. Immunity, 2, 561-572. http://dx.doi.org/10.1016/1074-7613(95)90001-2
[7] Harris, J., Hope, J.C. and Keane, J. (2008) Tumor Necrosis Factor Blockers Influence Macrophage Responses to Mycobacterium tuberculosis. Journal of Infectious Diseases, 198, 1842-1850.
http://dx.doi.org/10.1086/593174
[8] Algood, H.M., Lin, P.L., Yankura, D., Jones, A., Chan, J. and Flynn, J.L. (2004) TNF Influences Chemokine Expression of Macrophages in Vitro and That of CD11b+ Cells in Vivo during Mycobacterium tuberculosis Infection. Journal of Immunology, 172, 6846-6857. http://dx.doi.org/10.4049/jimmunol.172.11.6846
[9] Zhou, Z., Connell, M.C. and MacEwan, D.J. (2007) TNFR1-Induced NF-KappaB, but Not ERK, p38MAPK or JNK Activation, Mediates TNF-Induced ICAM-1 and VCAM-1 Expression on Endothelial Cells. Cell Signal, 19, 1238- 1248. http://dx.doi.org/10.1016/j.cellsig.2006.12.013
[10] Keane, J. and Bresnihan, B. (2008) Tuberculosis Reactivation during Immune Suppressive Therapy in Rheumatic Diseases: Diagnostic and Therapeutic Strategies. Current Opinion in Rheumatology, 20, 443-449. http://dx.doi.org/10.1097/BOR.0b013e3283025ec2
[11] Bieber, J. and Kavanaugh, A. (2004) Consideration of the Risk and Treatment of Tuberculosis in Patients Who Have Rheumatoid Arthritis and Receive Biologic Treatments. Rheumatic Disease Clinics of North America, 30, 257-270. http://dx.doi.org/10.1016/j.rdc.2004.01.003
[12] Rychly, D.J. and Dipiro, J.T. (2005) Infections Associated with Tumor Necrosis Factor-Alpha Antagonists. Pharmacotherapy, 25, 1181-1192. http://dx.doi.org/10.1592/phco.2005.25.9.1181
[13] Gutiérrez-Macías, A., Lizarralde-Palacios, E., Martínez-Odriozola, P. and Miguel-de la Villa, F. (2007) Tuberculous Peritonitis in a Patient with Rheumatoid Arthritis Treated with Adalimumab. Clinical Rheumatology, 26, 452-453. http://dx.doi.org/10.1007/s10067-005-0164-3
[14] Scheinfeld, N. (2005) Adalimumab: A Review of Side Effects. Expert Opinion on Drug Safety, 4, 637-641.
http://dx.doi.org/10.1517/14740338.4.4.637
[15] Mohan, A.K., Cote, T.R., Block, J.A., Manadan, A.M., Siegel, J.N. and Braun, M.M. (2004) Tuberculosis Following the Use of Etanercept, a Tumor Necrosis Factor Inhibitor. Clinical Infectious Diseases, 39, 295-299. http://dx.doi.org/10.1086/421494
[16] Yoo, W.H. (2012) Multiple Organ Tuberculosis of Lung, Pleura, and Peritoneum in Ankylosing Spondylitis during Adalimumab Therapy. Rheumatology International, 32, 787-790.
http://dx.doi.org/10.1007/s00296-009-1357-x
[17] Dascalu, C., Valceanu, A., Brennessel, D. and Bandagi, S. (2013) New Therapies, Increased Risk for Old Infections— Abdominal Tuberculosis Mimicking Colon Cancer during Adalimumab Treatment for Rheumatoid Arthritis. Journal of Clinical Rheumatology, 19, 297-299.
http://dx.doi.org/10.1097/RHU.0b013e31828c3d73
[18] Chow, K.M., Chow, V.C. and Szeto, C.C. (2003) Indication for Peritoneal Biopsy in Tuberculous Peritonitis. The American Journal of Surgery, 185, 567-573. http://dx.doi.org/10.1016/S0002-9610(03)00079-5
[19] Marshall, J.B. (1993) Tuberculosis of the Gastrointestinal Tract and Peritoneum. American Journal of Gastroenterology, 88, 989-999.
[20] Chow, K.M., Chow, V.C., Hung, L.C., Wong, S.M. and Szeto, C.C. (2002) Tuberculous Peritonitis-Associated Mortality Is High among Patients Waiting for the Results of Mycobacterial Cultures of Ascitic Fluid Samples. Clinical Infectious Diseases, 35, 409-413. http://dx.doi.org/10.1086/341898

Copyright © 2022 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.