Rheumatology Advance Access originally published online on March 27, 2008
Rheumatology 2008 47(5):738-739; doi:10.1093/rheumatology/ken113
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Rituximab in rheumatoid arthritis following anti-TNF-associated tuberculosis
1Department of Rheumatology and 2Department of Infectious Diseases, Addenbrooke's Hospital, Cambridge, UK.
Correspondence to: M. L. Burr, Rheumatology Research Unit, Addenbrooke's Hospital, Box 194 E6, Hills Road, Cambridge CB2 2QQ, UK. E-mail: marianlburr@doctors.org.uk
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SIR, The link between anti-TNF therapy and reactivation of latent tuberculosis (TB) is well recognized [1–3]. These patients are more likely to present with disseminated infection and this carries considerable mortality. Managing active RA in patients with anti-TNF-associated TB can therefore be challenging. We present the case of a patient with RA who was successfully treated with rituximab, a chimaeric anti-CD20 monoclonal antibody, after developing disseminated isoniazid-resistant TB following treatment with infliximab.
A 54-yr-old white female with a 15-yr history of severe