Infecciones asociadas al uso de inhibidores de alfa-TNF (anti a-TNF)
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El factor de necrosis tumoral alfa -FNTes en componente de la respuesta de las citocinas que se encuentran en los desórdenes inflamatorios crónicos. Algunos productos son: etanercept, infliximab, adalimumab más recientes golimumab y certolizumab se indican en control de artritis reumatoide, osteoartritis y psoriasis entre otros. El riesgo de infección asociado con estos biológicos es de 28%. Son las infecciones respiratorias altas, sinusitis, infecciones urinarias y de tejidos blandos las más comunes. Los gérmenes específicos oportunistas más aislados son herpes zoster, Pneumocystis jiroveci y Mycobacterium tuberculosis, Coccidiodes, Histoplasma, Aspergilos, Listeria y Candida. En México hemos observado y estudiado varios casos con tuberculosisis (Tb) pulmonar y extrapulmonar donde los antecedentes de uso de estos medicamentos asociados a la reactivación se correlaciona causa-efecto, por lo que se realiza revisión de la literatura y se hacen consideraciones sobre este nuevo grupo de riesgo de inmunocomprometidos con infecciones que ponen en peligro la vida y son de difícil diagnóstico.
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