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Cerebral Tuberculosis in a Patient Following Treatment With Infliximab for Ankylosing Spondylitis: A Case Report

Ankylosing spondylitis (AS) mainly belongs to the group of axial spondylitis. It is a chronic inflammatory disease that primarily affects the spine, but can also affect peripheral joints. It is characterized by inflammatory lower back pain and morning stiffness. Tuberculosis is still a cause of morb...

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Autores principales: Cretu, Ioana, Geoanta, Corina, Bogheanu, Oana-Irina, Milicescu, Mihaela, Bojinca, Mihai, Costache, Mihai, Cirstoiu, Catalin, Cretu, Bogdan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10195647/
https://www.ncbi.nlm.nih.gov/pubmed/37216132
http://dx.doi.org/10.7759/cureus.39117
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author Cretu, Ioana
Geoanta, Corina
Bogheanu, Oana-Irina
Milicescu, Mihaela
Bojinca, Mihai
Costache, Mihai
Cirstoiu, Catalin
Cretu, Bogdan
author_facet Cretu, Ioana
Geoanta, Corina
Bogheanu, Oana-Irina
Milicescu, Mihaela
Bojinca, Mihai
Costache, Mihai
Cirstoiu, Catalin
Cretu, Bogdan
author_sort Cretu, Ioana
collection PubMed
description Ankylosing spondylitis (AS) mainly belongs to the group of axial spondylitis. It is a chronic inflammatory disease that primarily affects the spine, but can also affect peripheral joints. It is characterized by inflammatory lower back pain and morning stiffness. Tuberculosis is still a cause of morbidity and mortality in developing countries. Management of patients with AS consists of patient education, spinal mobility exercises, non-steroidal anti-inflammatory drugs (NSAIDs), corticotherapy, and anti-tumor necrosis factor alpha (TNF-α) biological agents. Anti-TNF-α biological agents have changed the prognosis of patients with AS. They contain anti-TNF-α monoclonal antibodies (golimumab, infliximab, adalimumab, certolizumab) and the soluble TNF-α receptor (etanercept). Hip and knee involvement is common in patients with AS, as evidenced in radiographs as bone erosion and joint space narrowing. The patient may have severe pain, stiffness, and loss of mobility, and the treatment involves surgery for joint arthroplasty. We present the case of a 63-year-old patient with axial spondyloarthritis who was treated with infliximab and developed cerebral tuberculosis after three years of biological therapy. The purpose of the study is to determine the possibility of resuming biological therapy at the time of AS reactivation, given the long-term treatment and adverse reactions of cortisone therapy (aseptic necrosis of the femoral head).
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spelling pubmed-101956472023-05-20 Cerebral Tuberculosis in a Patient Following Treatment With Infliximab for Ankylosing Spondylitis: A Case Report Cretu, Ioana Geoanta, Corina Bogheanu, Oana-Irina Milicescu, Mihaela Bojinca, Mihai Costache, Mihai Cirstoiu, Catalin Cretu, Bogdan Cureus Internal Medicine Ankylosing spondylitis (AS) mainly belongs to the group of axial spondylitis. It is a chronic inflammatory disease that primarily affects the spine, but can also affect peripheral joints. It is characterized by inflammatory lower back pain and morning stiffness. Tuberculosis is still a cause of morbidity and mortality in developing countries. Management of patients with AS consists of patient education, spinal mobility exercises, non-steroidal anti-inflammatory drugs (NSAIDs), corticotherapy, and anti-tumor necrosis factor alpha (TNF-α) biological agents. Anti-TNF-α biological agents have changed the prognosis of patients with AS. They contain anti-TNF-α monoclonal antibodies (golimumab, infliximab, adalimumab, certolizumab) and the soluble TNF-α receptor (etanercept). Hip and knee involvement is common in patients with AS, as evidenced in radiographs as bone erosion and joint space narrowing. The patient may have severe pain, stiffness, and loss of mobility, and the treatment involves surgery for joint arthroplasty. We present the case of a 63-year-old patient with axial spondyloarthritis who was treated with infliximab and developed cerebral tuberculosis after three years of biological therapy. The purpose of the study is to determine the possibility of resuming biological therapy at the time of AS reactivation, given the long-term treatment and adverse reactions of cortisone therapy (aseptic necrosis of the femoral head). Cureus 2023-05-17 /pmc/articles/PMC10195647/ /pubmed/37216132 http://dx.doi.org/10.7759/cureus.39117 Text en Copyright © 2023, Cretu et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Cretu, Ioana
Geoanta, Corina
Bogheanu, Oana-Irina
Milicescu, Mihaela
Bojinca, Mihai
Costache, Mihai
Cirstoiu, Catalin
Cretu, Bogdan
Cerebral Tuberculosis in a Patient Following Treatment With Infliximab for Ankylosing Spondylitis: A Case Report
title Cerebral Tuberculosis in a Patient Following Treatment With Infliximab for Ankylosing Spondylitis: A Case Report
title_full Cerebral Tuberculosis in a Patient Following Treatment With Infliximab for Ankylosing Spondylitis: A Case Report
title_fullStr Cerebral Tuberculosis in a Patient Following Treatment With Infliximab for Ankylosing Spondylitis: A Case Report
title_full_unstemmed Cerebral Tuberculosis in a Patient Following Treatment With Infliximab for Ankylosing Spondylitis: A Case Report
title_short Cerebral Tuberculosis in a Patient Following Treatment With Infliximab for Ankylosing Spondylitis: A Case Report
title_sort cerebral tuberculosis in a patient following treatment with infliximab for ankylosing spondylitis: a case report
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10195647/
https://www.ncbi.nlm.nih.gov/pubmed/37216132
http://dx.doi.org/10.7759/cureus.39117
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