Disseminated tuberculosis and lung cancer associated with infliximab treatment of rheumatoid arthritis.

Tumor necrosis factor (TNF)-α blockers have emerged as valuable tools in the treatment of active rheumatoid arthritis. The increased incidence of reactivated latent mycobacterial infection following institution of infliximab therapy has been reported.

However, less is known about the risk of malignancy with use of anti-TNF antibodies. We present a case of disseminated tuberculosis, possible infection with Mycobacterium fortuitum, and lung cancer in association with infliximab therapy in a 55-year-old man with active rheumatoid arthritis who had received previously isoniazid chemoprophylaxis.

We review the existing literature on anti-TNF agents and risk of tuberculosis and malignancy.