Infliximab for reactive arthritis secondary to Chlamydia trachomatis infection.
Reactive arthritis is an autoimmune disease that develops 2-4 weeks after a triggering infection, resulting mainly in synovitis/enthesitis of the lower limbs, but with a wide array of possible extra-articular manifestations. Most of the cases are self-limited, lasting some weeks to months, and respond well to nonsteroidal anti-inflammatory drugs (NSAIDs), but a considerable number of cases (about 20%) run a chronic disabling course, requiring immunosuppressants (methotrexate, sulphasalazine) to adequate control of the inflammatory symptoms. We describe, for the first time to our knowledge, a case of a Chlamydia trachomatis-related reactive arthritis refractory to methotrexate and sulphasalazine that was successfully treated with the monoclonal antibody anti-TNF-alpha and infliximab.
Schafranski
Marcelo Derbli
MD
Department of Internal Medicine and Rheumatology, Bom Jesus Hospital, Ponta Grossa, PR, Brazil. marceloschafranski@yahoo.com.br
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D016918:Arthritis, Reactive / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology; D002690:Chlamydia Infections / Q000150:complications / Q000382:microbiology*; D002692:Chlamydia trachomatis / Q000472:pathogenicity*; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D000069285:Infliximab; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D011241:Prednisone / Q000627:therapeutic use; D012460:Sulfasalazine / Q000627:therapeutic use; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D012460:Sulfasalazine; D000069285:Infliximab; D011241:Prednisone; D008727:Methotrexate