A
report of the death of an arthritis patient from Dublin
A man who died after he suffered an adverse drug reaction to medication he was prescribed to treat suspected tuberculosis (TB) had no evidence of TB at autopsy.
Whilst he was diagnosed with TB it is not known how that diagnosis was obtained
screening tests for TB (carried out prior to starting a new drug for his arthritis) suggested an active immune reaction to TB. Mr Dowdall had “significant exposure” to TB at the age of 13 when he shared a bedroom with his brother who had TB.
In some countries screening by IGRA before anti TNF medication is
recommended
Screening for latent tuberculosis infection is indicated prior to the administration of anti-TNF-a therapy. Due to the better sensitivity and specificity of IGRA tests, their incorporation into current recommendations should serve to detect more cases at risk for reactivation of latent tuberculosis infection and to prevent unnecessary prophylaxis with its potentially adverse effects in patients with false-positive TST.
