Certain drugs used in the treatment for rheumatoid arthritis increase the risk of tuberculosis. These include corticosteroids, methotrexate and anti-tumour necrosis factor (TNF) agents. More recently, a possibility that leflunomide is associated with increased risk of tuberculosis has been discussed.¹ A 36-year-old woman presented to the Department of Medicine, Himalayas Institute of Medical Sciences, Dehradun, Uttaranchal, India, with active rheumatoid arthritis for 4 years. She had been treated unsuccessfully with methotrexate in the past. Investigation showed normocytic-normochromic anaemia with a normal total and differential leucocyte counts, and a normal platelet count: an erythrocyte sedimentation rate (ESR) (Westergren’s Method) of …