Visceral leishmaniasis infection in a rheumatoid arthritis patient treated with infliximab.
Anti-TNFalpha strategies can result in significant clinical benefits in rheumatoid arthritis (RA), but with an increased rate of opportunistic infections. Visceral leishmaniasis (VL) is a severe disease that can develop in immunocompromised hosts, principally in HIV patients. VL in RA patients treated with TNFalpha antagonists is an extremely rare event, and only one case has been described. Here we report a case of VL, occurring after 9 infusions of infliximab in association with azathioprine, in a patient who developed blood cytopenia, fluctuant fever, and splenomegaly.
Fabre
S
S
Department of Immuno-Rheumatology, CHU Lapeyronie, 371 av Doyen Gaston Giraud, 34090 Montpellier, France. s-fabre@chu-montpellier.fr
Gibert
C
C
Lechiche
C
C
Dereure
J
J
Jorgensen
C
C
Sany
J
J
D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000008:administration & dosage*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000069285:Infliximab; D007898:Leishmaniasis, Visceral / Q000150:complications* / Q000276:immunology; D008875:Middle Aged; D009894:Opportunistic Infections / Q000276:immunology / Q000469:parasitology*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab