Reactivation of Tuberculosis in Patients with Ankylosing Spondylitis on Tofacitinib Therapy

Ankylosing spondylitis (AS) is an inflammatory disorder affecting the axial skeleton and peripheral joints. It is immune-mediated common in the second and third decades having symptoms such as sacroiliitis, synovitis, and difficulty in movement of the spine. It is treated with nonsteroidal anti-inflammatory drugs (NSAIDs), JAK 2 inhibitors, and other biologicals such as infliximab and etanercept. This is the case report of a 24-year-old male student who presented with lower backache, and morning stiffness which improved with activity. On investigation, his HLA B 27 was positive and erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were raised. He was treated with tofacitinib for 1 year, later he developed pott's spine as its side effect. This case report represents the rare side effect of tofacitinib as pott's spine.