title: Kaposi's sarcoma after T-cell costimulation blockade with abatacept in rheumatoid arthritis: a case report.
abstract: OBJECTIVE
  Kaposi's sarcoma (KS) is a malignant neoplasm caused by HHV-8, a pathogen that leads to endothelial cell transformation when host defences are weakened.
  
  
  METHODS
  Here we report the first case of KS during treatment with abatacept, a biologic agent targeting T-cell costimulation. The patient was a 64-year-old female with rheumatoid arthritis who developed multiple firm, purple-reddish nodules on the dorsal aspect of the right hand. Histological examination confirmed KS.
  
  
  CONCLUSIONS
  Although a direct causal relationship between KS development and abatacept treatment cannot be proved, we hypothesize a role for costimulation blockade.
authors.affiliation: Rheumatology Outpatient Clinic, San Giovanni di Dio Hospital, Crotone, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Olivo
authors.affiliation: Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy.
authors.forename: R D
authors.initials: RD
authors.lastname: Grembiale
authors.affiliation: Pathology Unit, San Giovanni di Dio Hospital, Crotone, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Tallarigo
authors.affiliation: Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Russo
authors.affiliation: Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy.
authors.forename: G
authors.initials: G
authors.lastname: De Sarro
authors.affiliation: Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ursini
mesh_terms: D000069594:Abatacept / Q000008:administration & dosage / Q000009:adverse effects*; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D005260:Female; D019288:Herpesvirus 8, Human / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D012514:Sarcoma, Kaposi / Q000139:chemically induced* / Q000473:pathology; D013601:T-Lymphocytes / Q000276:immunology
chemical_list: D018501:Antirheumatic Agents; D000069594:Abatacept
keywords: CTLA4-Ig; HHV-8; Kaposi's sarcoma; T cells; T cells costimulation; abatacept; case report; costimulation; human herpesvirus 8; rheumatoid arthritis