DEVELOPMENT OF ACTIVE PULMONARY TUBERCULOSIS DURING ACTH AND CORTISONE THERAPY

Abstract

Of a group of patients with rheumatoid arthritis who had been receiving corticotrophin (ACTH) and/or cortisone in our arthritis clinic, clinical manifestations of active tuberculosis developed in one. Because of the possibility that the appearance of fulminating clinical tuberculosis in this patient and the administration of the aforementioned widely used hormones were related rather than coincidental events, we consider it advisable to publicize this case history in detail. REPORT OF A CASE A white man aged 58, whose rheumatoid arthritis first became evident in January, 1949, was first admitted to Wadsworth Hospital in July, 1949, because of hepatitis. His arthritis was noted to improve markedly while he was jaundiced, but recurred with the subsidence of the hepatitis. A liver biopsy at that time was interpreted as demonstrating cirrhosis and superimposed hepatitis. He was discharged in October, 1949, and got along well until May, 1950, when he had a generalized exacerbation