<prompt> A 45 years old male patient a known case of Crohns disease presents with recent flare-ups suggestive of fistulas. He was admitted and treated with immune-suppressive. Unfortunately, he got reactivation of his tuberculosis as a result of the side effects of the treatment. Which of the following immunosuppressive medication is the most likely cause of his TB reactivation?MethotrexateInfliximabAzathioprineMizorbine  <response>: Answer: b InfliximabTREATMENT OF INFLAMMATORY BOWEL DISEASEAminosalicylates 5-aminosalicylic acid formulations known as mesalamine: acts topically in the colon. Sulfasalazine 5-ASA sulphapyridine, olsalazine 5-ASA5-ASA and balsalazide 5-ASA amino benzoyl Alanine are effective for the treatment of ulcerative colitis. 5-ASA is the first line treatment for mild ulcerative colitis.Glucocorticoids Prednisone, hydrocortisone, prednisolone and budesonide: in moderate to severe ulcerative colitis and Crohns disease.Purine analogs Azathioprine and 6-MP: maintenance for remission of ulcerative colitis and Crohns disease.Methotrexate: induction and maintenance of remission of Crohns disease but not ulcerative colitis.Anti TNFa therapy: Infliximab, adalimumab and certolizumab are useful in Crohns disease.Natalizumab: targeted against a-4 subunit of integrins. Should not be used with other immunosuppressants due to the risk of progressive multifocal leukoencephalopathy. Infliximab therapy is associated with incidence of respiratory infections; potential reactivation of tuberculosis or other granulomatous infections with subsequent dissemination. Candidates for infliximab therapy should be tested for latent tuberculosis with purified protein derivative and chest radiographs, and patients who test positive should be treated prophylactically with isoniozid. Infliximab also is contraindicated in patients with severe congestive heart failure. 