Ruxolitinib-associated tuberculosis – A rare complication of a novel drug!

2016-11-07T08-16-08Z
Source: International Journal of Medical Science and Public Health
Vinod R Patil, Chandrakala S, Nilesh P Wasekar, Farah Jijina, Aniket B Mohite.
Primary myelofibrosis (PMF) is a myeloproliferative disorder characterized by bone marrow fibrosis, abnormal cytokine expression, abnormal proliferation of megakaryocytes, and splenomegaly. Ruxolitinib (INCB018424) is a novel nonspecific Janus-like kinase inhibitor available for the management of PMF as it reduces spleen size and gives significant symptomatic relief. Very few case reports are available depicting opportunistic infections associated with this drug. We present a case of 35-year-old female - A known case of PMF on follow-up since 7 years. She was started on ruxolitinib in view of symptomatic progressive splenomegaly and weight loss. She was asymptomatic till 4th month of starting drug when she developed fever, body ache, and right axillary swelling. The right axillary lymph node biopsy revealed necrotizing granulomatous lymphadenopathy of tuberculous etiology (acid-fast bacilli [AFB] positive). X-ray of the chest was normal. She was started on antituberculosis (TB) treatment, and ruxolitinib was also continued. Patient is currently asymptomatic and has gained weight. She is on continuation phase of anti-TB treatment.


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