Sara HDIYE, Samir MRABTI, Imane KARAM ˡ, Saad ASSILA, Mohamed ALLAOUI, Soukaina BAHHA, Rachida SAOUAB, Hassan SEDDIK
Journal: Medpeer Publisher
ISSN: 3066-2737
Volume: 3
Issue: 5
Date of Publication: 2026/05/07
Tuberculosis (TB) is a known opportunistic infection in patients receiving anti-tumor necrosis factor alpha (anti-TNFα) therapy. Extrapulmonary TB, particularly isolated splenic involvement, is rare and difficult to diagnose. We report a case of a Crohn’s disease patient treated with adalimumab who developed isolated splenic TB despite a negative baseline QuantiFERON-TB test. The patient presented with asthenia and general deterioration without respiratory symptoms. Imaging revealed hypodense splenic lesions. Splenic biopsy confirmed Mycobacterium tuberculosis by histopathology and PCR. Anti-TNF therapy was discontinued, and standard antitubercular therapy was initiated, resulting in clinical improvement. This case highlights the importance of ongoing vigilance for TB during anti-TNF therapy, even after negative initial screening.
Splenic tuberculosis; Crohn’s disease; Adalimumab; Anti-TNF; Extrapulmonary tuberculosis; QuantiFERON
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