Professional Documents
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Anti-Tumour Necrosis Factor Agents and
Anti-Tumour Necrosis Factor Agents and
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Another granulomatous disease, disseminated histoplasmosis, has also been reported with these therapies: in a
review of the Food and Drug Administration passive
surveillance database, nine cases of invasive disseminated
histoplasmosis have been reported in patients receiving
infliximab and one case in a patient who had received
etanercept.69 Although these data are preliminary, they again
suggest that this disorder may be a more significant problem
with infliximab.
152
Management
Tuberculin testing
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04 mm*
59 mm
10 mm
*The decision to treat latent infection in such cases should be made on an individual
basis in conjunction with a tuberculosis specialist.
Conclusions
Anti-TNF agents are an important addition to treatments for
rheumatoid arthritis and other autoimmune disorders. That
these agents have been suggested to increase the risk of
active tuberculosis is not surprising given the central role
of TNF in the host defence against tuberculosiskilling of
M tuberculosis by macrophages, granuloma formation,
apoptosis, and prevention of dissemination of infection to
other sites. Differences in potency and route of
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References
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