{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T22:54:21Z","timestamp":1770072861931,"version":"3.49.0"},"reference-count":14,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,11,4]]},"abstract":"<jats:p>A 42-year-old man receiving anti-tumour necrosis factor \u03b1 (anti-TNF\u03b1) therapy with adalimumab due to psoriatic arthritis presented with a 2-month-old anal ulcer. An apical right lung infiltrate was found in his chest X-ray, although he had no pulmonary symptoms. Two biopsies of the ulcer were taken and reported as granulomatous, necrotising, with chronic inflammation (first), and as hyperplasic epidermis with linfocitary infiltrate and the presence of plenty of plasmatic cells (second). Histochemical techniques, including Ziehl-Neelsen, Grocott and periodic acid-Schiff stains, and PCR for<jats:italic>Mycobacterium tuberculosis<\/jats:italic>on both biopsies were negative. Serology for HIV, syphilis and hepatitis were also negative. In the second biopsy culture, moderate colonies of<jats:italic>M. tuberculosis<\/jats:italic>finally grew. The patient started a four-drug antituberculosis regimen. Adalimumab was discontinued and etanercept introduced after 2\u2005months of antituberculosis therapy. The patient remained on therapy for 9\u2005months with complete ulcer resolution.<\/jats:p>","DOI":"10.1136\/bcr-2014-206976","type":"journal-article","created":{"date-parts":[[2014,11,24]],"date-time":"2014-11-24T11:28:04Z","timestamp":1416828484000},"page":"bcr2014206976","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Anal tuberculosis complicating anti-TNF\u03b1 therapy"],"prefix":"10.1136","volume":"2014","author":[{"given":"Nuria","family":"Luqu\u00edn","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar","family":"Masi\u00e1","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ra\u00fal","family":"Noguera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F\u00e9lix","family":"Guti\u00e9rrez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,11,24]]},"reference":[{"key":"2025042707002835000_2014.nov24_1.bcr2014206976.1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.118935"},{"key":"2025042707002835000_2014.nov24_1.bcr2014206976.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2006.11.005"},{"key":"2025042707002835000_2014.nov24_1.bcr2014206976.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2009.01770.x"},{"key":"2025042707002835000_2014.nov24_1.bcr2014206976.4","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-200690"},{"key":"2025042707002835000_2014.nov24_1.bcr2014206976.5","first-page":"345","article-title":"Ano-perianal tuberculosis\u2014solving a clinical dilemma","volume":"5","author":"Gupta","year":"2005","journal-title":"Afr Health Sci"},{"key":"2025042707002835000_2014.nov24_1.bcr2014206976.6","first-page":"1488","article-title":"Anal tuberculosis: report of two cases and literature review","volume":"87","author":"Horland","year":"1992","journal-title":"Am J Gastroenterol"},{"key":"2025042707002835000_2014.nov24_1.bcr2014206976.7","doi-asserted-by":"publisher","DOI":"10.1159\/000171688"},{"key":"2025042707002835000_2014.nov24_1.bcr2014206976.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2007.09.004"},{"key":"2025042707002835000_2014.nov24_1.bcr2014206976.9","first-page":"989","article-title":"Tuberculosis of the gastrointestinal tract and peritoneum","volume":"88","author":"Marshall","year":"1993","journal-title":"Am J Gastroenterol"},{"key":"2025042707002835000_2014.nov24_1.bcr2014206976.10","doi-asserted-by":"crossref","unstructured":"Hatzara C , Hadziyannis E , Kandili A et al . 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