| Visceral leishmaniasis and anti-TNF-alpha therapy: case report and review of the literature. | |
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MedLine Citation:
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PMID: 19604446 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Visceral leishmaniasis (VL) is an extremely rare example of opportunistic infection in patients treated with TNF-alpha antagonists and only a few cases have been described. In this paper risk factors, clinical features, diagnostic work-up and outcome of patients developing VL under biologic therapy are described. METHODS: Case report and review of the published cases of VL in patients under biologic treatment. RESULTS: We retrieved six patients, including ours, all of whom presented anarchic fever and pancytopenia. In 5 cases, splenomegaly was detected. The same number of patients came from endemic areas for VL. In the majority of the cases a bone marrow examination was not diagnostic, requiring the performance of a second one and/or the execution of other diagnostic tests. One fatal outcome was observed. CONCLUSION: Even if VL represents a sporadic complication of biologic treatments, its presence should always be suspected in patients developing a triad of signs and symptoms constituted by fluctuant fever, pancytopenia and splenomegaly, especially if coming from endemic areas. In these cases an extensive diagnostic work-up must be warranted. Atypical and confusing features may resemble autoimmune diseases at presentation and during the course of the illness. |
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Authors:
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F De Leonardis; M Govoni; A Lo Monaco; F Trotta |
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Publication Detail:
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Type: Case Reports; Journal Article; Review |
Journal Detail:
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Title: Clinical and experimental rheumatology Volume: 27 ISSN: 0392-856X ISO Abbreviation: Clin. Exp. Rheumatol. Publication Date: 2009 May-Jun |
Date Detail:
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Created Date: 2009-07-16 Completed Date: 2009-10-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8308521 Medline TA: Clin Exp Rheumatol Country: Italy |
Other Details:
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Languages: eng Pagination: 503-6 Citation Subset: IM |
Affiliation:
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Section of Rheumatology, Department of Clinical and Experimental Medicine, University of Ferrara, 44100, Ferrara, Italy. dlnfnc@unife.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Antibodies, Monoclonal / therapeutic use* Antirheumatic Agents / therapeutic use* Arthritis, Psoriatic / drug therapy* Humans Leishmania donovani Leishmaniasis, Visceral / diagnosis*, physiopathology Male Middle Aged Opportunistic Infections / diagnosis*, physiopathology Tumor Necrosis Factor-alpha / antagonists & inhibitors*, physiology |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Monoclonal; 0/Antirheumatic Agents; 0/Tumor Necrosis Factor-alpha; 0/infliximab |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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