Abdominal pain in a patient with ankylosing spondylitis under treatment with infliximab.

In patients suffering from ankylosing spondylitis, silent inflammatory bowel disease (IBD) is frequent. Furthermore, spondylarthritis may be the first manifestation of IBD. We describe the case of a patient suffering from ankylosing spondylitis who presented with abdominal pain. The patient had been treated over 2 1 / 2 years with infliximab. Although the initial clinical presentation seemed to suggest new-onset IBD as the cause of the abdominal pain, it eventuated that the patient was suffering from a severe abdominal manifestation of tuberculosis likely due to reactivation of latent tuberculosis by the anti-TNF agent.