Nadhya Allia, Lita Diah Rahmawati

Abstract views = 138 times | downloads = 76 times


Ankylosing spondylitis (AS) is one of the most common types of spondylarthritis (SpA) and Disease-Modifying Antirheumatic Drug (DMARD) is one of the modalities for treating the disease. An increased risk of latent tuberculosis infection (LTBI) reactivation in rheumatic patients receiving DMARD has been reported. Management of patients with rheumatic diseases who are also infected with LTBI needs to be understood in order not to
become active TB. We reported a case of a 57-year-old man with AS. Patient was planned to be treated with DMARD so that hepatitis and TB screening performed. It was discovered that this patient had LTBI. The prophylactic therapy for TB was given. DMARD therapy started 1 month after TB prophylactic therapy was given. For monitoring the disease progression,
anamnesis, physical, laboratory, and radiology examination performed regularly.


Latent TB Infection; Ankylosing Spondylitis; DMARD

Full Text:



Ai JW, Ruan QL, Liu QH, Zhang WH. 2016. Updates on the risk factors for latent

tuberculosis reactivation and their managements. EmergMicrob Infect.2016:5:h.1-8

Badan Penelitian dan Pengembangan Kesehatan Kementrian RI. 2013. Epidemilogi

Penyakit Reumatik. Epidemiologi Penyakit di Indonesia. Jakarta: Balai Pustaka

Brassard P, Kezouh A, Suissa S. 2006. Antirheumatic Drugs and the Risk of

Tuberculosis. Clin Infect Dis 2006;43:717-722

Braun J, van der Berg R, Baraliakos X, Boehn H, Burgos-Vargas R, Collantes-Estevez E,

et al. 2011. 2010 Update of the ASAS/EULAR recommendations for the management

of ankylosing spondylitis. Ann Rheum Dis 2011;70:896-904

Cantini F, Nannini C, Niccoli L, Iannone F, Delogu G, Garlaschi G, et al. 2015.

Guidance for the management of patients with latent tuberculosis infection requiring

biologic therapy in rheumatology and dermatology clinical practice. Autoimmun

Rev, 2015;14:h.503-9

CDC. 2013. Latent tuberculosis infection: a guide for primary health care providers.

Atlanta: Centers for Disease Control and Prevention

Fitzgerald O. 2013. Psoriatik arthritis. In: Firestein GS, et al. (eds) Kelley’s Textbook of

Rheumatology. 9th ed. Philadelphia: Saunders Elsevier, 2013. pp. 1401-1419

Iannone F, Cantini F & Lapadula G. 2014. Diagnosis of latent tuberculosis and

prevention of reactivation in rheumatic patients receiving biologic therapy:

international recommendations. J Rheumatol, 2014;91:h.41-6

Inanc N, Aydin SZ, Karakurt S, Ataqunduz P, Yavuz S et al. 2009. Agreement between

Quantiferon-TB gold test and tuberculin skin test in the identification of latent

tuberculosis infection in patients with rheumatoid arthritis and ankylosing

spondylitis. J Rheumatol;36:12:h.2675-81

Iseman MD. 2011. Mycobacterial infections in era of modern biologic agents. Am J Med

Sci, 341:h.278-80

Kementrian Kesehatan Republik Indonesia. 2014. Pedoman nasional pengendalian

tuberkulosis. Jakarta: Kemenkes RI; 2014

Perhimpunan Reumatologi Indonesia. 2014. Rekomendasi Perhimpunan Reumatologi

Indonesia (IRA) untuk spondiloartropati. Jakarta: Perhimpunan Reumatologi

Indonesia; 2014:h. 2-3

Perhimpunan Reumatologi Indonesia. 2017. Pedoman Penapisan dan Tata Laksana

Infeksi Tuberkulosis Laten pada Pasien Penyakit Reumatik yang Akan Mendapatkan

Terapi DMARD Biologik. Jakarta: Perhimpunan Reumatologi Indonesia; 2017:h.11-

Rudwaleit M, van der Heijde D, Landewe R, Listing J, Akkoc N, Brandt J, Chou CT, et

al. 2011 The Assessment of SpondyloArthritis international Society Classification

kriteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann

Rheum Dis 2011;70:25-31

Smolen JS, Landewe R, Breedveld FC, Buch M, Burnester G, Dougados M. 2013.

EULAR recommendations for the management of rheumatoid arthritis with synthetic

and biological disease-modifying anturheumatic drugs: 2013 update. Ann Rheum

Dis. 2013;0;h.1-18.

van der Heijde D, Ramiro S, Landewe R, Baraliakos X, van den Bosch F, et al.,2017.

update of the ASAS-EULAR management recommendations for axial

spondyloarthtritis. Ann Rheum Dis 2017;76:978-991

van der Linden S, Valkenburg HA, Cats A. 1984. Evaluation of diagnostic criteria for

ankylosing spondylitis: A proposal for modification of the New York kriteria. Arthritis

Rheum 1984;27:361-8

van der Linden SM, van der Heijde D, Maksynowych WP. 2013. Ankylosing spondylitis.

In: Firestein GS et al. (eds) Kelley’s Textbook of Rheumatology. 9th ed. Philadelphia:

Saunders Elsevier, 2013. pp. 1366-89

WHO. 2017. Global Tuberculosis Report 2017. In:

WHO. 2015. Guideline on the management of latent tuberculosis infection. Geneva:

World Health Organization

Wollheim FA. 2013. Enteropathric arthritis. In: Firestein GS, et al. (eds) Kelley’s

Textbook of Rheumatology. 9th ed. Philadelphia: Saunders Elsevier, 2013. pp. 1420-

Xu Z, Xu P, Fan W, Yang G, Wang J, Cheng Q, & Yu M. 2017. Risk of infection in

patients with spondyloarthritis and ankylosing spondylitis receiving antitumor

necrosis factor therapy: A meta-analysis of randomized controlled trials. In:

Experimental and Therapeutic Med 14: 3491-3500

Yan Yu DT, McGonagle D, Marzo-Ortega H, van den Bosch F, Leirisalo-Repo M. 2013.

Undifferentiated spondyloarthritis and reactive arthriti. In: Firestein GS, et al. (eds)

Kelley’s Textbook of Rheumatology. 9th ed. Philadelphia: Saunders Elsevier, 2013.



  • There are currently no refbacks.

Copyright (c) 2021 Nadhya Allia, Lita Diah Rahmawati

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.


View CIMRJ Stats

e-ISSN: 2721-544X

Lisensi Creative Commons
This Journal is licensed under Creative Commons Attribution-ShareAlike 4.0 International License.