Journal
OPEN FORUM INFECTIOUS DISEASES
Volume 9, Issue 8, Pages -Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/ofid/ofac367
Keywords
tuberculosis; immune reconstitution inflammatory syndrome; adalimumab; TNF-alpha inhibitor; central nervous system tuberculosis
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TB-IRIS is an inflammatory response to M. tuberculosis infection that occurs following immune system restoration. Patients treated with inhibitors may face risks of developing IRIS when developing active tuberculosis infection.
Immune reconstitution inflammatory syndrome to tuberculosis (TB-IRIS) is an inflammatory response to M. tuberculosis infection that arises following restoration of the immune system and is increasingly recognized as a risk in patients treated with tumor necrosis factor a inhibitors who develop active tuberculosis infection. We present the case of a 19-year-old man treated with adalimumab for Crohn's disease who presented with disseminated miliary tuberculosis. His treatment course was complicated by central nervous system TB-IRIS following cessation of his immunosuppression. We review the presentation and differential diagnosis of TB-IRIS, as well as risk factors for developing IRIS and the treatment of IRIS in this population.
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