Development of Generalized Tuberculosis During Tumor Necrosis Factor-Alpha Inhibitor Therapy for Rheumatic Disease
https://doi.org/10.58838/2075-1230-2026-104-3-72-80
Abstract
The risk of developing tuberculosis (TB) increases in rheumatology patients receiving tumor necrosis factor-alfa (TNF- α) inhibitor therapy. This paper presents two clinical case reports demonstrating the difficulties in diagnosing and treating generalized TB that occurred during TNF-α inhibitor therapy in patients with ankylosing spondylitis. In both patients, the time to TB detection exceeded three months due to the pronounced clinical manifestations of the multiorgan inflammation (fever, polyserositis, generalized lymphadenopathy), the lack of regular TB monitoring during biologic therapy, and initial focus on oncology screening. Atypical clinical and radiological manifestations prompted an escalation of the baseline glucocorticoid therapy, which further contributed to TB progression and generalization. In both cases, TB was successfully cured following prolonged treatment.
About the Authors
N. V. Makarova
Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Department of Health
Russian Federation
Russian Federation
Natalia V. Makarova, Candidate of Medical Sciences, Phthisiatrician, City Clinical Diagnostic Center
10 Stromynka St., 107014 Moscow;
Tel.: +7 (499) 268-00-05
L. D. Guntupova
Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Department of Health
Russian Federation
Russian Federation
Lidia D. Guntupova, Doctor of Medical Sciences, Head of the City Clinical Diagnostic Center
10 Stromynka St., 107014 Moscow;
Tel.: +7 (499) 268-00-05
M. V. Kalinina
Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Department of Health
Russian Federation
Russian Federation
Marina V. Kalinina, Candidate of Medical Sciences, Phthisiologist, 2nd Tuberculosis Surgical Department, Clinic № 2
10 Stromynka St., 107014 Moscow;
Tel.: +7 (499) 268-00-05
K. K. Kasenova
Moscow Research and Clinical Center for Tuberculosis Control of the Moscow Government Department of Health
Russian Federation
Russian Federation
Kumus K. Kasenova, Phthisiologist, 6th Tuberculosis Pulmonary Department, Clinic № 2
10 Stromynka St., 107014 Moscow;
Tel.: +7 (499) 268-00-05
G. V. Lukina
A.S. Loginov Moscow Clinical Scientific Cener of the Moscow Healthcare Department
Russian Federation
Russian Federation
Galina V. Lukina, Doctor of Medical Sciences, Professor,
Head of Rheumatology Department
1 Novogireevskaya St., Bldg. 1, 111123 Moscow;
Tel.: +7 (495) 304-30-39
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Review
For citations:
Makarova N.V., Guntupova L.D., Kalinina M.V., Kasenova K.K., Lukina G.V. Development of Generalized Tuberculosis During Tumor Necrosis Factor-Alpha Inhibitor Therapy for Rheumatic Disease. Tuberculosis and Lung Diseases. 2026;104(3):72-80. (In Russ.) https://doi.org/10.58838/2075-1230-2026-104-3-72-80
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