A 73-year-old female was suffering from RA since 1983. In December 2008, administration of ADA 40 mg every 2 weeks was initiated due to insufficient efficacy of conventional DMARDs. Prior to initiation of ADA, a positive TST was obtained, and the patient received INH for 9 months. ADA therapy was effective against RA. However, in February 2010, she returned to the hospital with cellulitis on both legs. The cellulitis improved with administration of antibiotics (imipenem) and temporary discontinuation of ADA. In May 2011, treatment with antibiotics was associated with slight fever, elevated serum CRP, and continuous elevation of neutrophil CD64 (up to 18,831 molecules/cell) (Figure 3). ADA was discontinued and further examination revealed diffuse reticulonodular shadows in the lung fields through chest X-ray and CT scan, suggesting the development of miliary TB (Figure 4). Acid-fast bacilli were observed in smear preparations from sputum and gastric juice, and a sputum PCR test was positive for Mycobacterium tuberculosis. The patient was transferred to a hospital which had a TB ward. Noncaseating epithelioid granuloma was observed in bronchial and alveolar specimens obtained through bronchoscopy (Figure 4). Biopsy specimens from a cellulitis-like lesion on the patient's right lower limb (Figure 4) also revealed erythema induratum of Bazin (Figure 4). The levels of neutrophil CD64 decreased below the cutoff value after anti-TB treatment with improvement of clinical manifestations.