title: Clinical manifestation of selective IgA deficiency evidence after anti-TNF-α treatment in a psoriatic arthritis patient: case report.
abstract: It is known that the use of anti-TNF-α drugs is related to an increased incidence of infective diseases. This therapy can not be administered to patients having active infections and it has to be considered with caution in case of acquired or congenital immunodeficiency diseases. We report the case of a 28-years-old man affected by psoriatic arthritis; he developed some infections during treatment with TNF-α blockers. The infections were caused by a selective IgA deficiency, that was not evident before the anti-TNF-α blockers administration and disappeared after withdrawing the biological therapy. This case-report draws our attention to the possibility of cases of subclinical immunodeficiency, unknown by the patients, but important in the prognosis and in the therapeutic approach to these diseases. Therefore, it is important to evaluate carefully the immunologic status of patients during the pre-therapeutic screening for TNF-α blocking therapy.
authors.affiliation: Department of Clinical and Experimental Medicine, Rheumatology Research Unit, University Federico II, Naples, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Iervolino
authors.forename: M
authors.initials: M
authors.lastname: Lofrano
authors.forename: M N D
authors.initials: MN
authors.lastname: Di Minno
authors.forename: F
authors.initials: F
authors.lastname: Foglia
authors.forename: R
authors.initials: R
authors.lastname: Scarpa
authors.forename: R
authors.initials: R
authors.lastname: Peluso
mesh_terms: D000068879:Adalimumab; D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects*; D015535:Arthritis, Psoriatic / Q000150:complications / Q000188:drug therapy*; D016572:Cyclosporine / Q000627:therapeutic use; D004198:Disease Susceptibility; D005499:Folliculitis / Q000209:etiology*; D006560:Herpes Labialis / Q000209:etiology*; D006801:Humans; D017098:IgA Deficiency / Q000150:complications / Q000175:diagnosis*; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D043183:Irritable Bowel Syndrome / Q000150:complications; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D016269:Milk Hypersensitivity / Q000150:complications; D009181:Mycoses / Q000209:etiology*; D013280:Stomatitis / Q000209:etiology*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D016572:Cyclosporine; D000068879:Adalimumab; D008775:Methylprednisolone