OLGU SUNUMLARI
COVID-19 Pandemisinde TNF İnhibitörlerinin Unutulmaması Gereken Bir Yan Etkisi: Akciğer Tüberkülozu
A Side Effect of TNF Inhibitors That Should not be Forgotten in the COVID-19 Pandemic: Pulmonary Tuberculosis
Received Date : 16 Oct 2021
Accepted Date : 01 Jun 2022
Available Online : 08 Jun 2022
Hüseyin KAPLANa, Senem ŞAŞa, Emre ŞENKÖYa, Gizem CENGİZa, Hüseyin DEMİRb
aErciyes Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, Romatoloji BD, Kayseri, Türkiye
bİzmir Tınaztepe Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon ABD, İzmir, Türkiye
Doi: 10.31609/jpmrs.2021-86680 - Makale Dili: TR
J PMR Sci. 2022;25(3):386-9
ÖZET
Ankilozan spondilit (AS); primer olarak aksiyal iskeleti etkileyen,
ayrıca periferik eklemlerde ve entezis bölgelerinde de inflamasyona neden
kronik inflamatuar bir hastalıktır. Erkeklerde daha sık görülür ve prevalansı
%0,5-1,6 arasında bildirilmektedir. Tümör nekrozis faktör alfa (TNF-ɑ),
hastalığın etiyopatogenezinde önemli bir sitokindir ve TNF’yi bloke eden biyolojik
tedaviler son yıllarda yaygın bir şekilde AS’li hastalarda kullanılmaktadır.
Tüberküloz enfeksiyonları, anti-TNF’lerin önemli bir yan
etkisidir. Monoklonal antikorlar olan adalimumab ve infliksimabta riskin
daha yüksek olduğu rapor edilmektedir. Koronavirüs hastalığı-2019 [coronavirus
disease-2019 (COVID-19)] pandemisinde kronik hastalığı olan bireylerin
hastanelere başvurularında ciddi azalma meydana gelmiştir. Bu da
hastaların komplikasyonlarla hastaneye başvurma ihtimalini ortaya çıkarmaktadır.
Bu olgu sunumunda, COVID-19 pandemisi sürecinde adalimumab
tedavisi altında tüberküloz enfeksiyonu gelişen AS tanılı bir vakayı
sunuyoruz.
Anahtar Kelimeler: Ankilozan spondilit; TNF inhibitörleri; akciğer tüberkülozu
ABSTRACT
Ankylosing spondylitis (AS) is a chronic inflammatory disease
that primarily affects the axial skeleton and also causes inflammation
in the peripheral joints and enthesis areas. It is more common in men and its
prevalence is reported to be between 0.5 and 1.6%. Tumor necrosis factor
alpha (TNF-ɑ) is an important cytokine in the etiopathogenesis of the disease,
and biologic therapies that block TNF have been widely used in patients
with AS in recent years. Tuberculosis infections are an important side
effect of anti-TNFs. The risk is reported to be higher with the monoclonal
antibodies adalimumab and infliximab. In the coronavirus disease-2019
(COVID-19) pandemic, there has been a serious decrease in the applications
of individuals with chronic diseases to hospitals. This raises the possibility
of patients presenting to the hospital with complications. In this case
report, we present a case of AS who developed tuberculosis infection under
adalimumab treatment during the COVID-19 pandemic.
Keywords: Ankylosing spondylitis; TNF inhibitors; pulmonary tuberculosis
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