| Visceral leishmaniasis and macrophagic activation syndrome in a patient with rheumatoid arthritis under treatment with adalimumab. | |
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MedLine Citation:
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PMID: 20378385 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Visceral leishmaniasis is a protozoan infection usually asymptomatic, but can progress to fatal disease in immunocompromised hosts, especially in HIV patients. Visceral leishmaniasis is rare among patients under immunosuppressive therapies, and even more among patients under anti-TNF-alpha treatment, where only four cases have been described. OBJECTIVE: 1) To describe a patient with rheumatoid arthritis receiving adalimumab who developed fever, pancytopenia, splenomegaly, and extreme hyperferritinemia. 2) To perform a review of the published cases of visceral leishmaniasis and anti-TNF-alpha therapy, and cases of coexisting leishmaniasis and macrophagic activation syndrome by search in PubMed (period 1991-2008). RESULTS: Visceral leishmaniasis was established by bone marrow aspiration, and although there was no histological confirmation, according to HLH-2004 criteria, a secondary macrophagic activation syndrome was established. The patient had a favourable outcome. CONCLUSION: We report herein the fifth case of visceral leishmaniasis in a patient under TNF-alpha therapy, and the first one, to our knowledge, presenting a consequent secondary macrophagic activation syndrome. |
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Authors:
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Anna Moltó; Lourdes Mateo; Natalia Lloveras; Alejandro Olivé; Sonia Minguez |
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Publication Detail:
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Type: Case Reports; Journal Article Date: 2010-04-07 |
Journal Detail:
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Title: Joint, bone, spine : revue du rhumatisme Volume: 77 ISSN: 1778-7254 ISO Abbreviation: Joint Bone Spine Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-25 Completed Date: 2010-08-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100938016 Medline TA: Joint Bone Spine Country: France |
Other Details:
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Languages: eng Pagination: 271-3 Citation Subset: IM |
Copyright Information:
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Copyright 2010. Published by Elsevier SAS. |
Affiliation:
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Rheumatology Section, Hospital Universitari Germans Trias I Pujol, Ctra del Canyet s/n, 08916 Badalona, Spain. anmoltre@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Antibodies, Monoclonal
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administration & dosage,
adverse effects* Antirheumatic Agents / administration & dosage* Arthritis, Rheumatoid / complications, drug therapy*, immunology Humans Immunocompromised Host Leishmaniasis, Visceral / complications, immunology* Macrophage Activation Syndrome / complications, immunology* Male Middle Aged Tumor Necrosis Factor-alpha / antagonists & inhibitors |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Monoclonal; 0/Antirheumatic Agents; 0/Tumor Necrosis Factor-alpha; 0/adalimumab |
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