Abstract
Here, we report a 56-year-old patient with rheumatoid arthritis (RA) who had been treated with methotrexate and sulfuasalazine, but the disease activity remained high. Therefore, we planned TNF-blocker treatment for this patient. A tuberculin skin test was positive, we started anti-tuberculosis (TB) chemoprophylaxis with isoniazid (INH). However, liver dysfunction was appeared after 2 weeks from the start of INH. Therefore, we discontinued INH transiently and tried the desensitization of INH. However, interstitial pneumonia was developed 2 weeks after the re-start of INH, we decided to stop the INH prophylaxis. Interstitial pneumonia was improved by corticosteroid treatments. This case report shows that INH-induced IP can be occurred during the course of anti-TB chemoprophylaxis in patients with RA.
MeSH terms
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Adrenal Cortex Hormones / therapeutic use
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Antitubercular Agents / adverse effects*
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Arthritis, Rheumatoid / complications
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Arthritis, Rheumatoid / diagnosis
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Arthritis, Rheumatoid / drug therapy*
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Arthritis, Rheumatoid / immunology
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Biopsy
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Chemical and Drug Induced Liver Injury / etiology
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Humans
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Immunosuppressive Agents / adverse effects*
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Isoniazid / adverse effects*
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Lung Diseases, Interstitial / chemically induced*
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Lung Diseases, Interstitial / diagnosis
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Lung Diseases, Interstitial / drug therapy
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Male
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Middle Aged
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Predictive Value of Tests
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Severity of Illness Index
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Tomography, X-Ray Computed
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Treatment Outcome
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Tuberculin Test
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Tuberculosis / diagnosis
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Tuberculosis / etiology
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Tuberculosis / prevention & control*
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Tumor Necrosis Factor-alpha / antagonists & inhibitors
Substances
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Adrenal Cortex Hormones
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Antitubercular Agents
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Immunosuppressive Agents
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Tumor Necrosis Factor-alpha
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Isoniazid