Tuberculous monoarthritis after treatment with adalimumab in Crohn's disease.

Anti-tumor necrosis factor alpha (TNF-α) drugs have demonstrated their usefulness in treating some autoimmune rheumatic diseases and inflammatory bowel disease. Its affinity to TNF−α prevents the activation of proinflammatory cascade. Adalimumab is a human monoclonal antibody that is administered subcutaneously. Several safety studies have concluded that it is well tolerated but not without adverse effects. Most of them are mild although there are cases of lymphoma, demyelinating processes and infections. Active tuberculosis is a contraindication to its administration according to the technical data sheet. However, latent tuberculosis requires initiating prophylaxis against tuberculosis. Below we present a case of tuberculous monoarthritis of the wrist, in the context of miliary tuberculosis, in a patient with Crohn’s disease treated with adalimumab.