Study data from A. Fonollosa et al provide new insights into tuberculosis
2007 NOV 5 -- "Background Etanercept is a tumor necrosis factor (TNF) inhibitor that has been licensed in the United States for the treatment of adult and juvenile rheumatoid arthritis as well as psoriatic arthritis. Reactivation of tuberculosis is a complication of its use," investigators in Barcelona, Spain report. "We report the first case of tuberculous uveitis due to etanercept. We performed a clinical chart review. Case A 58-year-old Caucasian woman was referred to our hospital for chronic unilateral granulomatous panuveitis of the right eye (RE). She was on etanercept and methotrexate for rheumatoid arthritis. Since the patient was immunosuppressed with etanercept and since the uveitis was granulomatous we considered tuberculosis as a possible etiology. An aqueous humor tap was performed and sent for polymerase chain reaction analyses of Herpes simplex, Herpes zoster, and Mycobacterium tuberculosis (MT). This last test was positive. Another aqueous humor sample was taken and sent for microscopic examination of sputum for acid-fast bacilli and culture, both of which were positive for MT. A diagnosis of tuberculous uveitis was established; the patient was treated with rifampin, isoniazid pyrazinamide, and ethambutol and etanercept was stopped. Four months later there were no cells in the anterior chamber and the vitreous was clear. To our knowledge this is the first reported case of tuberculous uveitis following treatment with etanercept," wrote A. Fonollosa and colleagues. The researchers concluded: "This etiology has to be considered in patients taking this drug who present with intraocular inflammation." Fonollosa and colleagues published their study in Graefes Archive for Clinical and Experimental Ophthalmology (Tuberculous uveitis after treatment with etanercept. Graefes Archive for Clinical and Experimental Ophthalmology, 2007;245(9):1397-1399). For additional information, contact A. Fonollosa, Hospital General Valle Hebron, Barcelona 36427, Spain. The publisher of the journal Graefes Archive for Clinical and Experimental Ophthalmology can be contacted at: Springer, 233 Spring Street, New York, NY 10013, USA. Keywords: Spain, Barcelona, Arthritis, Dermatology, Drugs, Etanercept, Granuloma, Methotrexate, Mycobacteria, Mycobacterium Tuberculosis, Ophthalmology, Pharmaceuticals, Rheumatoid Arthritis, Therapy, Treatment, Uveitis. This article was prepared by Pain & Central Nervous System Week editors from staff and other reports. Copyright 2007, Pain & Central Nervous System Week via NewsRx.com.
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