Authors: J. Fialová; M. Kojanová Authors‘ workplace: Dermatovenerologická klinika 1. LF UK a VFN, Praha, přednosta doc. MUDr. Ondřej Kodet, Ph.D. Published in: Čes-slov Derm, 101, 2026, No. 1, p. 26-29 Category: Case interpretation
The authors describe the case of a 21-year-old patient with chronic plaque psoriasis treated with adalimumab for 7 years, who developed active pulmonary and subsequently CNS tuberculosis, although screening (pulmonary examination, chest X-ray, and Quantiferon TB Gold test) performed three months before their onset excluded latent infection. The case highlights the risk of tuberculosis reactivation during biological treatment with anti-TNF-α drugs. The course of the infection, complications including neurological manifestations, and the decision-making process leading to the switch to risankizumab therapy after the end of 12 months of antituberculosis treatment are described. At week 16, the application of risankizumab led to the healing of psoriasis symptoms (PASI 0), which persisted even at the last check-up 6 months after the start of treatment. The case study underlines the importance of careful monitoring of TB symptoms in patients on immunosuppressive therapy and the importance of interdisciplinary cooperation in the management of treatment.
tuberculosis – adalimumab – risankizumab – Psoriasis – anti-TNF – biologic therapy – CNS tuberculoma – latent TB reactivation
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