Tuberculosis-associated IRIS in a young non-HIV patient undergoing TNF-α blockade for ankylosis spondylitis: a rare case report from Italy

Patients receiving anti-TNF-α therapy are at increased risk of developing tuberculosis (TB). While immune reconstitution inflammatory syndrome (IRIS) is classically associated with HIV-infected individuals initiating antiretroviral therapy, it has also been reported in HIV-negative patients following the initiation of anti-tubercular treatment. We present a case of a non-HIV patient who developed IRIS after being diagnosed with TB while on anti-TNF-α therapy. The optimal management of IRIS in this setting remains unclear, although corticosteroids have been used with varying success. Some authors suggest that continuation of anti-TNF-α agents during IRIS may be beneficial. Our case highlights the diagnostic and therapeutic challenges in managing TB-IRIS in non-HIV patients and the need for further research in this population.