title: Mucosal relapse of visceral leishmaniasis in a child treated with anti-TNFα.
abstract: Visceral leishmaniasis is an enzootic parasitosis present across the Mediterranean Basin. Some consider it an opportunistic parasite. We report the case of a girl treated with anti-tumour necrosis factor alpha (anti-TNFα) for juvenile idiopathic arthritis who had previously presented with visceral leishmaniasis. Two and a half years later, she presented a tumour-like mass in the nasal mucous membrane caused by Leishmania parasites. Leishmania infantum is classically responsible for visceral leishmaniasis, but pure mucocutaneous leishmaniasis has also been described. To our knowledge, this is the first observation of a recurrence of visceral leishmaniasis in the mucocutaneous form. The occurrence of atypical forms and presentations in those on anti-TNF therapy should be considered.
authors.affiliation: Centre Hospitalier Régional Universitaire de Montpellier, Hôpital Arnaud de Villeneuve, Service de Pédiatrie Générale et Infectiologie et Immunologie Clinique, 371, avenue du Doyen Gaston Giraud, 34295 Montpellier cedex 5, France; Université Montpellier 1, Faculté de Médecine de Montpellier, Montpellier, France. Electronic address: e-jeziorski@chu-montpellier.fr.
authors.forename: E
authors.initials: E
authors.lastname: Jeziorski
authors.affiliation: Centre Hospitalier Régional Universitaire de Montpellier, Laboratoire de Parasitologie-Mycologie, Montpellier, France.
authors.forename: J
authors.initials: J
authors.lastname: Dereure
authors.affiliation: Centre Hospitalier Régional Universitaire de Montpellier, Hôpital Lapeyronnie, Service des Urgences Pédiatriques, Montpellier, France.
authors.forename: G
authors.initials: G
authors.lastname: Mac Bullen
authors.affiliation: Centre Hospitalier Régional Universitaire de Montpellier, Hôpital Gui de Chauliac, Service d'Oto-Rhino-Laryngologie, Montpellier, France.
authors.forename: C
authors.initials: C
authors.lastname: Blanchet
authors.affiliation: Centre Hospitalier Régional Universitaire de Montpellier, Hôpital Arnaud de Villeneuve, Service de Pédiatrie Générale et Infectiologie et Immunologie Clinique, 371, avenue du Doyen Gaston Giraud, 34295 Montpellier cedex 5, France.
authors.forename: C
authors.initials: C
authors.lastname: Ludwig
authors.affiliation: Centre Hospitalier Régional Universitaire de Montpellier, Hôpital Gui de Chauliac, Service d'Anatomopathologie, Montpellier, France.
authors.forename: V
authors.initials: V
authors.lastname: Costes
authors.affiliation: Centre Hospitalier Régional Universitaire de Montpellier, Hôpital Arnaud de Villeneuve, Service de Pédiatrie Générale et Infectiologie et Immunologie Clinique, 371, avenue du Doyen Gaston Giraud, 34295 Montpellier cedex 5, France.
authors.forename: M
authors.initials: M
authors.lastname: Rodière
mesh_terms: D001171:Arthritis, Juvenile / Q000150:complications / Q000188:drug therapy*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D018314:Leishmania infantum / Q000302:isolation & purification*; D007898:Leishmaniasis, Visceral / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D009297:Nasal Mucosa / Q000469:parasitology*; D012008:Recurrence; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: C439524:TNF protein, human; D014409:Tumor Necrosis Factor-alpha
keywords: Anti-TNF therapeutic; Leishmaniasis