PT  - JOURNAL ARTICLE
AU  - Pavel Gavrilov
AU  - Viacheslav Zhuravlev
AU  - Liudmila Archacova
AU  - Sergey Dolgikh
TI  - Pulmonary tuberculosis (PT) in patients taking the TNF-a inhibitor inflixinab (INF)
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p1948
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p1948.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p1948.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Depression of TNF-a functions by its inhibitors not only suppresses the immune-inflammatory process, but also results in certain depression of an organism immune protection level and in increase in its susceptibility to TB. The medical and X-ray date of 263 patients taking INF for treatment of rhematoid disease were analyzed. The features of PT in patients taking INF were studied. All the patients every 6 months undergo X-ray examination of the lungs. The PT has developed in 8 patients taking INF and was diagnosed in 4,6±2,5 months of therapy, the number of infusions was from 2 to 6. The PT was diagnosed after respiratory complaints, in 5 patients the MBT was isolated from the sputum. Studying of Mantoux test with 2 TE before the INF course has shown that this method does not provide any reliable information, because all the patients before that have been taking immunosuppressive hormonal therapy for a long time. The x-ray archive analysis has not resulted in identification of any pathological changes. In case of detection of the disease in 5 patients there were visible multiple changes in both lungs, it was mostly changes in the upper lobes of the lungs. 3 patients with focal dissimination had infiltrates with small destruction cavities. All the patients had typical expressed bilateral enlargement of all groups of lymph nodes, tumor type with polycyclicity of the contours. The lymph nodes structure was normal. Rapid development of PT affection is typical for all the patients with tendency to generalisation and expressed hyperplasia of intrathoracic lymph nodes. In order to determine the risk of TB before administration of INF it is necessary to carry out quantiferon test and SCT.