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  • Oral presentation
  • Open Access

Tuberculosis reactivation during novel, biologic therapy

  • Cristina Popescu1, 2Email author,
  • Violeta Molagic1,
  • Cătălin Tilişcan1, 2,
  • Ruxandra Moroti1, 2,
  • Adriana Hristea1, 2,
  • Mihaela Rădulescu1, 2,
  • Raluca Mihăilescu1, 2,
  • Daniela Munteanu1,
  • Iulia Niculescu1, 2,
  • Raluca Năstase1,
  • Raluca Dulama1,
  • Alina Lobodan1,
  • Raluca Hrişcă1,
  • Raluca Jipa1,
  • Anca-Ruxandra Negru1,
  • Irina Lăpădat1,
  • Roxana Petre1,
  • Mircea Chiotan1,
  • Cornel Camburu1,
  • Viorica Poghirc1,
  • Raluca Popescu1 and
  • Victoria Aramă1, 2
BMC Infectious Diseases201313(Suppl 1):O25

Published: 16 December 2013


Rheumatoid ArthritisTuberculosisPsoriasisInfliximabEtanercept


Biologic immunotherapy such as anti-TNF or monoclonal antibody against CD20 protein revolutionized the treatment of autoimmune diseases. Unfortunately, the patients receiving this therapy are at higher risk for bacterial or fungal infections, and at risk for reactivation of latent viral infections and latent tuberculosis. We present a series of patients receiving biologic therapy, admitted in the Adults 3 Department of the National Institute for Infectious Diseases “Prof. Dr. Matei Balş” for prolonged fever.

Case report

All of the patients were diagnosed with tuberculosis. One patient was treated with rituximab for non-Hodgkin lymphoma, 2 patients were treated with infliximab for rheumatoid arthritis, one patient was treated with infliximab for ankylosing spondylitis and one patient was treated with etanercept for severe psoriasis. Two of the patients were diagnosed with pulmonary tuberculosis and for three patients the localization of tuberculosis was not identified. All of the patients had quantiferon TB gold positive. Only one of the patients had positive microbiologic tests for tuberculosis. All of the patients had a good therapeutic response after anti-tuberculous therapy. None of the patients had been tested for latent tuberculosis prior to initiation of biologic therapy.


We emphasize the importance of anti-tuberculosis prophylaxis for patients diagnosed with latent tuberculosis, before the start of biologic therapy. The diagnosis of latent tuberculosis remains an important issue especially in a country with high incidence of tuberculosis.

Authors’ Affiliations

National Institute for Infectious Diseases “Prof. Dr. Matei Balş”, Bucharest, Romania
Carol Davila University of Medicine and Pharmacy, Bucharest, Romania


© Popescu et al; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.