Adalimumab-Induced Pulmonary Adverse Event In A Patient With Ankylosing Spondylitis: A Case Report.

[摘要] Adalimumab, a tumor necrosis factor alpha antagonist, is widely used to treat autoimmunediseases such as ankylosing spondylitis. However, this drug is associated with both infectious and non- infectious pulmonary adverse events, including a reactivation of latent tuberculosis. We report anddiscuss the case of a 49-year-old patient with ankylosing spondylitis, treated with Adalimumab, whopresented dyspnea, fever, night sweats, fatigue, general malaise and cough with discharge. On physicalexamination, presence of ventilatory movements with crackles in the left lung base. Laboratory andimaging tests with hematological and biochemical parameters and chest computed tomography withnormal pattern. The symptoms ceased when treatment with Adalimumab was stopped, but after one yearlatent tuberculosis was evidenced. The diagnosis of bronchopneumonia was interpreted as an adversereaction to Adalimumab. With the subsequent results of positive tuberculin tests and a history of previousexposure to tuberculosis prior to treatment with an immunobiological agent, we can consider that therespiratory manifestations could already be symptoms of latent tuberculosis reactivation. This caseshows the importance of considering the possibility of diagnosing drug-induced lung disease, includingtuberculosis, in patients treated with Adalimumab.

[学科分类] 工程和技术（综合）

[关键词] adalimumab;ankylosing spondylitis;tumor necrosis factor- α;tuberculosis.