CNS TB-IRIS Following Cessation of Adalimumab in an Adolescent With Crohn's Disease

Overview

Journal Open Forum Infect Dis

Specialty Infectious Diseases

Date 2022 Aug 11

PMID 35949406

Authors

Elizabeth Christian

Alicia Johnston

Affiliations

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Abstract

Immune reconstitution inflammatory syndrome to tuberculosis (TB-IRIS) is an inflammatory response to infection that arises following restoration of the immune system and is increasingly recognized as a risk in patients treated with tumor necrosis factor α inhibitors who develop active tuberculosis infection. We present the case of a 19-year-old man treated with adalimumab for Crohn's disease who presented with disseminated miliary tuberculosis. His treatment course was complicated by central nervous system TB-IRIS following cessation of his immunosuppression. We review the presentation and differential diagnosis of TB-IRIS, as well as risk factors for developing IRIS and the treatment of IRIS in this population.

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