Karam Karam1, Johny Salem2, Jessy Fadel3, Mazen Farhat3, Lara Dalal4, Jose Taouk5, Marwan Haddad6, Bassem Sawan7, Charbel Fares6 and Elias Fiani8*
1Department of Gastroenterology, University of Balamand (UOB), Koura, Lebanon
2Department of Internal Medicine, University of Balamand, Koura (UOB), Lebanon
3Department of Gastroenterology, Saint Georges University of Beirut (SGUB), Beirut, Lebanon
4Faculty of Medicine, University of Balamand, Koura, Lebanon
5Department of Medical Imaging, University of Balamand, Beirut, Lebanon
6Department of Diagnostic Radiology, Mount Lebanon Hospital, Beirut, Lebanon
7Department of Pathology, Saint George Hospital University Medical Center, Beirut, Lebanon
8Department of Gastroenterology and Hepatology, Saint George Hospital University Medical Center, Beirut, Lebanon
*Corresponding Author: Elias Fiani, Department of Gastroenterology and Hepatology, Saint George Hospital University Medical Center, Beirut, Lebanon.
Received: April 26, 2024; Published: May 20, 2024
Adalimumab (ADA) is a tumor necrosis factor (TNF) inhibitor commonly used in inflammatory diseases like rheumatoid arthritis and inflammatory bowel disease due to its immunosuppressive effect through TNF alpha blockade. However, this treatment presents with the risk of contracting opportunistic infections like Tuberculosis (TB) that may be missed during initial screening. We discuss a case of an extrapulmonary miliary TB presenting 11 months after starting Adalimumab for treatment of Crohn’s disease, despite negative screening with tuberculin skin testing (TST). We discuss the appropriate screening modality to reduce false-negative latent TB screening prior to starting TNF inhibitors for patients diagnosed with Crohn’s disease.
Keywords: Adalimumab; Anti-tumor Necrosis Factor α; Miliary Tuberculosis; Extrapulmonary Tuberculosis; Crohn’s Disease; Interferon-γ Release Assays
Citation: Elias Fiani., et al. “Pitfalls of a Negative Tuberculin Skin Test When Used as a Screening Modality for Latent Tuberculosis Prior to Adalimumab Therapy: A Case Report". Acta Scientific Gastrointestinal Disorders 7.6 (2024): 08-11.
Copyright: © 2024 Elias Fiani., et al. 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 author and source are credited.