크론병 환자에서 Infliximab 치료 후 발생한 중증 다발성 결핵 1예

• Published in: The Korean journal of medicine pp. 337 - 341
• Main Authors: 김희욱, 장성일, 김번, 윤영훈, 변민광, 박효진, 이상인
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 01.09.2012
• Subjects: 내과학
• ISSN: 1738-9364; 2289-0769
• DOI: 10.3904/kjm.2012.83.3.337

크론병이 스테로이드에 불응성이거나 의존적인 경우, 누공 병변을 동반한 경우에 TNF-α 억제제인 infliximab이 효과적이나 결핵을 일으키는 부작용이 있다. 저자들은 결핵의 병력이 없고 선별검사상 음성인 크론병 환자에서 infliximab사용 후 다발성 중증 결핵이 합병된 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다. Infliximab, a tumor necrosis factor-α (TNF-α) inhibitor, has been approved for the treatment of a variety of inflammatory illnesses, including Crohn’s disease. However, infliximab can increase the risk of reactivation of latent tuberculosis (Tbc) infection by affecting host immune responses. Therefore, a screening test should be performed before the initiation of infliximab therapy, and patients with evidence of latent infection should be treated with prophylactic anti-Tbc therapy. Here, we report a case of multifocal disseminated tuberculosis after treatment with infliximab in a patient diagnosed with Crohn’s disease who had no past history of Tbc and showed a negative screening test. (Korean J Med 2012;83:337-341) KCI Citation Count: 0