Lymph nodal tuberculosis reactivation, anaemia and lack of efficacy: case reportA 38-year-old woman developed lymph nodal tuberculosis (TBC) reactivation during treatment with ruxolitinib for myelofibrosis (MF) and interferon-alpha-2b for essential thrombocythaemia (ET), and anaemia during treatment with isoniazid, rifampicin and ruxolitinib. Additionally, the woman exhibited lack of efficacy during treatment with anagrelide and hydroxycarbamide for ET [not all routes, dosages and outcomes stated; durations of treatments to reactions onsets not stated].The woman was diagnosed with essential thrombocythemia (ET) in 2011. Following the diagnosis, she started receiving aspirin [acetylsalicylic acid]. After 1 year, in 2012, hydroxycarbamide [hydroxyurea] therapy was initiated as platelet count was >1500000/ mmc. The dose of hydroxycarbamide was gradually increased due to poor control of the platelet count (825000 /mmc). In September 2015, anagrelide was added to hydroxycarbamide. However, anagrelide and hydroxycarbamide therapy was ineffective to treat ET. Hence, in February 2016, due to the lack of response to the double therapy and persistence of severe thrombocytosis (PLT:849000 /mmc), hydroxycarbamide and anagrelide were discontinued and subcutaneous interferon-alpha-2b [interferon-a] 3 millions units every other day was initiated. However, she developed flu-like syndrome and occasional headaches. Approximately 3 years from the initiation of interferon-alpha-2b, in September 2018, her clinical condition deteriorated with worsening of asthenia and headache. Additionally, thrombocytosis reoccurred and the spleen became palpable at 6cm from the costal margin.The woman's interferon-alpha-2b was therefore discontinued in November 2018. Subsequent new bone marrow biopsy revealed post-ET-MF with grade 2 reticulin fibrosis. Hence, in January 2019, she started receiving ruxolitinib 15mg twice a day for MF. Prior to initiation of ruxolitinib, a Mantoux test was performed which showed a previous exposition to Mycobacterium tuberculosis, with an unremarkable chest-RX. She did not receive TBC therapy due to the absence of strong recommendations for latent TBC treatment. In March 2019, her symptoms improved. However, after some days from initiation of ruxolitinib therapy, she developed frequent night sweats, chills, asthenia, and itchy lesions on the neck and face along with hard and painful lateral cervical right nodule. Subsequent physical examination revealed an almost unmovable mass with a hard parenchymal texture. A neck ultrasound was performed which showed rounded lymph nodes with maximum diameters of 24mm and 12mm. A total body CT scan revealed cervical lymphadenopathies, with central colliquation, along with 2 sub-centimetric calcific lymph nodes at the right lung hilum. No other lymph node enlargement at other sites or splenomegaly/hepatomegaly was found. Thereafter, she developed fever, malaise, and severe asthenia. Hence, she was referred to the emergency unit; and was sent to an urgent infective disease evaluatio...