title: Biological agents: investigation into leprosy and other infectious diseases before indication.
abstract: Biological agents are widely used for various immune-mediated diseases, with remarkable effectiveness in the treatment of rheumatoid arthritis (RA), psoriasis, psoriatic arthritis, ankylosing spondylitis and Crohn's disease. However, attention needs to be drawn to the adverse effects of these therapies and the risk of reactivating underlying granulomatous infectious diseases such as tuberculosis, leprosy, syphilis, leishmaniasis, among others. The objective of this paper is to describe a case of leprosy in a patient with RA using anti-TNF alfa, demonstrating the need for systematic investigation of skin lesions suggestive of leprosy in patients who require rheumatoid arthritis therapeutic treatment, especially in endemic regions like Brazil.
authors.affiliation: State Medical School of São José do Rio Preto, Base Hospital of São José do Rio Preto, Dermatology Department, São José do Rio PretoSP, Brazil.
authors.forename: João Roberto
authors.initials: JR
authors.lastname: Antônio
authors.affiliation: State Medical School of São José do Rio Preto, São José do Rio PretoSP, Brazil.
authors.forename: Rosa Maria Cordeiro
authors.initials: RM
authors.lastname: Soubhia
authors.affiliation: State Medical School of São José do Rio Preto, Department of Health Nursing, São José do Rio PretoSP, Brazil.
authors.forename: Vania Del Arco
authors.initials: Vdel A
authors.lastname: Paschoal
authors.affiliation: Regional Medical School Foundation, Base Hospital, São José do Rio PretoSP, Brazil.
authors.forename: Carolina Forte
authors.initials: CF
authors.lastname: Amarante
authors.affiliation: Regional Medical School Foundation, Base Hospital, São José do Rio PretoSP, Brazil.
authors.forename: Ana Regina Franchi
authors.initials: AR
authors.lastname: Travolo
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D001685:Biological Factors / Q000009:adverse effects*; D001706:Biopsy; D006801:Humans; D000069285:Infliximab; D007918:Leprosy / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000911:Antibodies, Monoclonal; D018501:Antirheumatic Agents; D001685:Biological Factors; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab