title: Serious musculoskeletal infections in children receiving anti-tumor necrosis factor-alpha therapy: a case series.
abstract: Anti-tumor necrosis factor-alpha (anti-TNF-alpha) agents are widely used to treat children with juvenile idiopathic arthritis (JIA) whose disease is resistant to conventional therapy. Although generally well tolerated, use of these agents has been associated with an increased risk of infection. In particular, in patients treated with anti-TNF-alpha agents, there is an increased susceptibility to infection by intracellular organisms such as tuberculosis, and common infections may present atypically or be more severe. We report four cases of serious musculoskeletal infections among 31 children with JIA being treated with anti-TNF-alpha agents, two of which were secondary to group A beta-hemolytic Streptococcus.
authors.affiliation: Division of Rheumatology, British Columbia's Children's Hospital, University of British Columbia, Vancouver, BC V6H 3V4, Canada. kmorishita@cw.bc.ca
authors.forename: Kimberly
authors.initials: K
authors.lastname: Morishita
authors.forename: Ross
authors.initials: R
authors.lastname: Petty
authors.forename: Robyn
authors.initials: R
authors.lastname: Cairns
authors.forename: Roxana
authors.initials: R
authors.lastname: Bolaria
authors.forename: David
authors.initials: D
authors.lastname: Cabral
authors.forename: Stuart
authors.initials: S
authors.lastname: Turvey
mesh_terms: D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000009:adverse effects; D001171:Arthritis, Juvenile / Q000276:immunology / Q000628:therapy*; D001424:Bacterial Infections / Q000139:chemically induced* / Q000276:immunology; D002675:Child, Preschool; D005260:Female; D006801:Humans; D000069285:Infliximab; D009140:Musculoskeletal Diseases / Q000139:chemically induced* / Q000276:immunology
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D000069285:Infliximab
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