Extra-pulmonary Reactivation of Latent Tuberculosis After Initiation of Anti-tumour Necrosis Factor Therapy for Inflammatory Bowel Disease—Are Current Screening Strategies Adequate?

We were interested to read a recent article by Carpio and colleagues,1 which reports on two cases of reactivation of latent tuberculosis infection [LTBI] with negative Mantoux and Quantiferon-TB Gold [QFT] assay screening before exposure to anti-tumour necrosis factor [anti-TNF] therapy in patients with inflammatory bowel disease [IBD]. Further to this, we would like to report our experience of a patient with extrapulmonary reactivation of tuberculosis after initiation of adalimumab therapy, despite previous negative screening test results for LTBI. A 52-year-old Nepalese woman, with a background of Crohn’s colitis and perianal fistulae, …