Late reactivation of spinal tuberculosis by low-dose methotrexate therapy in a patient with rheumatoid arthritis

Description: Rheumatology 2001; 40: 341-342
K. Binymin and R. G. Cooper Department of Rheumatology, University of Manchester, Rheumatic Diseases Centre, Hope Hospital, Stott Lane, Salford M6 8HD, UK
It is generally accepted that the use of chronic corticosteroid treatment predisposes to primary tuberculosis (TB) and reactivation of TB infection [1], and most of the TB cases reported in rheumatoid arthritis (RA) and other rheumatic diseases are associated with the use of long-term corticosteroid therapy [2]. A handful of cases of primary TB associated with the use of low-dose methotrexate (MTX) have been reported in patients with psoriasis [3]. We believe, however, that ours is the first case of TB reactivation associated with low-dose MTX therapy alone in a patient with RA.