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Table 3 Table summarizing cases published to date of mycobacterial disease in patients aged <18 years who were exposed to anti-TNFα agents

From: Tuberculosis in pediatric patients treated with anti-TNFα drugs: a cohort study

Pt Ref Primary disease Anti-TNFα drug Age/gender Time on drug Details on mycobacterial disease
Tuberculosis disease
1 [3] JIA Etanercept NR NR Extrapulmonary
2 [3] JIA Etanercept NR NR Extrapulmonary
3 [7] Polyarticular JIA Infliximab + MTX NR 2y Asymptomatic miliary TB (MTB PCR positive in sputum) with good response to 9-month standard treatment
4 [8] Systemic JIA Etanercept → infliximab + (previous extensive immunosuppressive therapy) 9y / female NR Subcutaneous cyst on the left wrist, after extensive microbiological studies, only MTB PCR in cyst fluid was positive. The child died after fulminant undiagnosed opportunistic pulmonary infection, 1 month after anti-TB drugs were implemented
5 [9] Systemic JIA Etanercept (previous CT and MTX) 9y / female 5wk Ankle arthritis with positive MTB culture and normal chest X-ray; good response to 12-month standard treatment
6 [10] SAPHO syndrome Adalimumab (previous CT) 17y / female 3y Meningeal and miliary TB presenting with septic shock; several PCR and cultures tested positive for MTB. Good response to therapy, but for neurologic sequelae. Adalimumab stopped 4 weeks earlier, suggesting immune reconstitution inflammatory syndrome
7 [11] Polyarticular JIA Infliximab (previous MTX) 13y / male 3 m TB pleuritis (cultures negative) with good response to anti-TB therapy
8 [12] Ulcerative colitis Infliximab (previous CT and azathioprine) 17y / male 8 m Miliary TB; the patient developed isoniazid-related hepatitis, but showed good response later on to an isoniazid-free regimen
9 [12] Crohn’s disease Infliximab 13y / female 2y Disseminated TB disease with good response to 9-month standard therapy
Nontuberculous mycobacterial disease
10 [13] Crohn’s disease Infliximab → adalimumab (previous CT) 12y / female 9 m Generalized lymphadenopathies due to culture-proven Mycobacterium avium complex infection; good response to ethambutol, clarithromycin and rifampin
11 [14] Mother’s Crohn disease Infliximab during gestation 3 m / male 36wk in utero Bottle-fed. BCG vaccination at 3 m of age; disseminated BCGitis leading to death 6 weeks later
  1. BCG bacillus Calmette-Guérin, CT corticosteroids, MTB Mycobacterium tuberculosis, MTX methotrexate, NR not reported, PCR polymerase chain reaction, Pt patient, Ref reference, SAPHO synovitis acne pustulosis hyperostosis and osteitis