An atypical presentation of visceral leishmaniasis infection in a patient with rheumatoid arthritis treated with infliximab.
Tumor necrosis factor alpha (TNF-alpha) is a cytokine, implicated in the pathogenesis of many inflammatory diseases, as well as in the immune-mediated response to infection, especially against intracellular pathogens. TNF-alpha antagonists have represented a revolution in the management of connective tissue diseases, such as rheumatoid arthritis. However, the use of these agents has been implicated with the emergence of a growing number of opportunistic infections. Here we report the case of a visceral Leishmaniasis in a 77-year-old woman who had been previously treated for rheumatoid arthritis with infliximab. The atypical presentation of this patient, previously treated with an anti-TNF-alpha biologic agent, where no splenomegaly or hepatomegaly was identified, is emphasized.
Kritikos
Konstantinos
K
1st Department of Internal Medicine, Evangelismos Hospital, Athens, Greece. konstantinoskritikos@yahoo.com
Haritatos
Evangelos
E
Tsigkos
Stelios
S
Gounari
Panagiota
P
Skrapari
Ioanna
I
Gounaris
Theodore
T
Sioula
Evangelia
E
D000368:Aged; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001856:Bone Marrow Examination; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D000069285:Infliximab; D007898:Leishmaniasis, Visceral / Q000175:diagnosis* / Q000276:immunology*; D007970:Leukopenia / Q000209:etiology
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D000069285:Infliximab