title: [Two cases of respiratory infection complicating treatment with infliximab].
abstract: Infliximab, an anti-TNF-alpha agent, is highly effective against rheumatoid arthritis and Crohn's disease. However, respiratory infection can occur as a complication. We report two cases complicated by respiratory infection following administration of infliximab. The first case, a 67-year-old woman with rheumatoid arthritis, developed pneumocystis pneumonia after three courses of infliximab therapy. The second case, a 31-year-old man with Crohn's disease, developed pulmonary tuberculosis after four courses of infliximab therapy. Respiratory complications associated with anti-TNF therapy include infectious diseases such as pneumocystis pneumonia, tuberculosis, and bacterial pneumonia. They often lead a fulminant course, and early diagnosis is essential. The final report of a survey of the initial 5000 cases with rheumatoid arthritis treated with infliximab in Japan was released in April 2006; pulmonary infectious complications included 22 cases of pneumocystis pneumonia, 14 cases of tuberculosis, and 108 cases of bacterial pneumonia. The growing use of anti-TNF therapy might lead to increasing pulmonary complications. Accumulation of similar cases is expected to elucidate the mechanism of the complications and methods for effective prophylaxis.
authors.affiliation: Department of Internal Medicine, Social Insurance Central General Hospital.
authors.forename: Shogo
authors.initials: S
authors.lastname: Kasai
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tokuda
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Otsuka
authors.forename: Yasumi
authors.initials: Y
authors.lastname: Ookohchi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Handa
authors.forename: Noriko
authors.initials: N
authors.lastname: Emoto
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yoshikawa
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D003424:Crohn Disease / Q000188:drug therapy; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000139:chemically induced*; D012141:Respiratory Tract Infections / Q000139:chemically induced*; D014396:Tuberculosis, Pleural / Q000139:chemically induced; D014397:Tuberculosis, Pulmonary / Q000139:chemically induced
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D000069285:Infliximab