크론병 환자에서 Infliximab 치료 후 발생한 중증 다발성 결핵 1예
A Case of Multiple Tuberculosis Associated with Infliximab Therapy in Crohn’s Disease
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초록
크론병이 스테로이드에 불응성이거나 의존적인 경우, 누공 병변을 동반한 경우에 TNF-α 억제제인 infliximab이 효과적이나 결핵을 일으키는 부작용이 있다. 저자들은 결핵의 병력이 없고 선별검사상 음성인 크론병 환자에서 infliximab사용 후 다발성 중증 결핵이 합병된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Infliximab, a tumor necrosis factor-α (TNF-α) inhibitor, has been approved for the treatment of a variety of inflammatory illnesses, including Crohn’s disease. However, infliximab can increase the risk of reactivation of latent tuberculosis (Tbc) infection by affecting host immune responses. Therefore, a screening test should be performed before the initiation of infliximab therapy, and patients with evidence of latent infection should be treated with prophylactic anti-Tbc therapy. Here, we report a case of multifocal disseminated tuberculosis after treatment with infliximab in a patient diagnosed with Crohn’s disease who had no past history of Tbc and showed a negative screening test. (Korean J Med 2012;83:337-341)
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