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Biological therapy using TNF-\u03b1 inhibitors is very effective but is associated with an increased risk of opportunistic infections, including active tuberculosis. Here, two cases are presented of patients with RA and psoriasis under biological therapy who developed very aggressive forms of disseminated tuberculosis, with a rapid progression to death. The authors conclude that patients undergoing biological therapy require thorough evaluation prior to initiating treatment, followed by continuous and rigorous monitoring by a multidisciplinary team during biological treatment, particularly in countries with a high incidence of tuberculosis.<\/jats:p>","DOI":"10.1177\/0300060518771273","type":"journal-article","created":{"date-parts":[[2018,5,24]],"date-time":"2018-05-24T02:05:55Z","timestamp":1527127555000},"page":"2961-2969","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Lethal disseminated tuberculosis in patients under biological treatment \u2013 two clinical cases and a short review"],"prefix":"10.1177","volume":"46","author":[{"given":"Elena","family":"Dantes","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania"},{"name":"Pneumology Adults department I, Clinical Pulmonology Hospital of Constanta, Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doina Ecaterina","family":"Tofolean","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania"},{"name":"Department of Pulmonology, Constanta County Clinical Emergency Hospital \u2018St. Apostol Andrei\u2019, Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariadna Petronela","family":"Fildan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania"},{"name":"Pneumology Adults department II, Clinical Pulmonology Hospital of Constanta, Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liviu","family":"Craciun","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania"},{"name":"Department of Pulmonology, Constanta County Clinical Emergency Hospital \u2018St. Apostol Andrei\u2019, Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Dumea","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania"},{"name":"Infectious Diseases Adults department I, Clinical Infectious Diseases Hospital of Constanta, Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioan Tiberiu","family":"Tofolean","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania"},{"name":"Department of Gastroenterology, Constanta County Clinical Emergency Hospital \u2018St. Apostol Andrei\u2019, Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Mazilu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Ovidius University of Constanta, Constanta, Romania"},{"name":"Department of Oncology, Constanta County Clinical Emergency Hospital \u2018St. Apostol Andrei\u2019, Constanta, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,5,23]]},"reference":[{"issue":"2","key":"bibr1-0300060518771273","doi-asserted-by":"crossref","first-page":"ii37","DOI":"10.1136\/ard.62.suppl_2.ii37","volume":"62","author":"Ehlers S.","year":"2003","journal-title":"Ann Rheum Dis"},{"key":"bibr2-0300060518771273","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/57.3.225"},{"key":"bibr3-0300060518771273","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1093\/rheumatology\/keq242","volume":"50","author":"Galloway JB","year":"2011","journal-title":"Rheumatology (Oxford)"},{"key":"bibr4-0300060518771273","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmii.2013.03.005"},{"key":"bibr5-0300060518771273","doi-asserted-by":"publisher","DOI":"10.1002\/art.24632"},{"key":"bibr6-0300060518771273","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.118935"},{"key":"bibr7-0300060518771273","volume":"8909834","author":"Cantini F","year":"2017","journal-title":"Mediators Inflamm"},{"key":"bibr8-0300060518771273","first-page":"659","volume":"54","author":"Arghir OC","year":"2013","journal-title":"Rom J Morphol Embryol"},{"key":"bibr9-0300060518771273","doi-asserted-by":"publisher","DOI":"10.4172\/2161-1068.1000206"},{"key":"bibr10-0300060518771273","first-page":"47","volume":"42","author":"Moyer TM","year":"2006","journal-title":"Hospital Physician"},{"key":"bibr11-0300060518771273","unstructured":"Arghir OC, Chiotan DI, Cioran NV,et\u00a0al. 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