Cutaneous leishmaniasis in a patient with ankylosing spondylitis using adalimumab.
Leishmaniasis is an anthropozoonosis caused by species of Leishmania and can have different clinical presentations, depending on the parasite-host relationship. Tumor necrosis factor-α (TNF-α) is a cytokine essential to infection control, especially against intracellular parasites such as Leishmania. Anti-TNF-α strategies have had a marked impact on the treatment of rheumatic diseases, but the clinical use of those antagonists has been accompanied by an increased report of infections. We report the first case of cutaneous leishmaniasis in a patient with ankylosing spondylitis treated with adalimumab and methotrexate in Brazil. We believe that, in this case, there was no association between the anti-TNF-α treatment and cutaneous leishmaniasis, because the disease was limited to only one ulcer that healed completely after treatment. More studies, however, are necessary to better understand the possible relationship between anti-TNF-α agents and leishmaniasis.
Hospital Geral de Fortaleza. nunesb@hotmail.com
Kirla Wagner Poti
KW
Gomes
André Nunes
AN
Benevides
Francisco José Fernandes
FJ
Vieira
Maggy Poti de Morais
MP
Burlamaqui
Marcos de Almeida e Pontes
Mde A
Vieira
Lysiane Maria Adeodato Ramos
LM
Fontenelle
D000068879:Adalimumab; D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016773:Leishmaniasis, Cutaneous / Q000209:etiology; D013167:Spondylitis, Ankylosing / Q000188:drug therapy*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab