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CASE REPORT
Year : 2017  |  Volume : 2  |  Issue : 4  |  Page : 25-27

Tuberculosis complicating Crohn's disease treated by anti-TNFα with negative quantiFERON


1 Gastroenterology Department of the Military Hospital Moulay Ismail-Meknes, Morocco
2 Radiology Department of the Military Hospital Moulay Ismail-Meknes, Morocco
3 Pneumo-phthisiology Department of the Military Hospital Moulay Ismail-Meknes, Morocco

Correspondence Address:
Youssef Touibi
Gastroenterology Department of the Military Hospital Moulay Ismail-Meknes
Morocco
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Source of Support: None, Conflict of Interest: None


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Anti-TNFα has reported an enormous Progress in the management of chronic inflammatory bowel disease, but this therapy is not without side effects. Infectious risk is the main side effect, especially tuberculosis. Hence the need for a pre-therapeutic assessment before starting the treatment. Materials and methods: These are two cases of tuberculosis complicating the treatment with anti-TNFα in patients monitored for crohn's disease. RESULTS: Two men followed for Crohn's disease with indication of anti-TNFα biotherapy, who had a complete phthisiological assessment with negative quantiFERON. Both patients showed respiratory signs with fever after the attack treatment. Imaging showed an appearance of tuberculous miliary disease in both patients. The search for mycobacteria was negative. The anti-TNFα treatment was interrupted with the introduction of an anti-bacillary treatment. Conclusion: Treatment with anti-TNFα requires careful attention, so following the recommendations is fundamental, with rigorous monitoring throughout the treatment period, since a normal pre-therapeutic assessment including a negative quantiFERON does not eliminate a potential risk.


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