著者
Shion Miyoshi Jin Takasaki Sohtaro Mine Masanori Kono Toru Igari Yuichiro Takeda Masayuki Hojo Haruhito Sugiyama
出版者
一般社団法人 日本内科学会
雑誌
Internal Medicine (ISSN:09182918)
巻号頁・発行日
vol.56, no.9, pp.1079-1083, 2017-05-01 (Released:2017-05-01)
参考文献数
16
被引用文献数
3

Anti-tumor necrosis factor α (anti-TNFα) agents increase the risk of tuberculosis (TB), but cases are rarely fatal. This report concerns a patient who was undergoing treatment with infliximab and presented with acute respiratory distress syndrome due to miliary TB without a miliary shadow. The findings of a pathological autopsy revealed innumerable granulomas in the organs, and the miliary nodules in the lung consisted of more unstructured granulomas. Anti-TNFα agents are unusual in the presentation of TB. It is important, particularly for patients receiving anti-TNFα agents, to constantly consider the possibility of TB and to prepare for appropriate management.