Visceral leishmaniasis and macrophagic activation syndrome in a patient with rheumatoid arthritis under treatment with adalimumab.
Joint Bone Spine
; 77(3): 271-3, 2010 May.
Article
em En
| MEDLINE
| ID: mdl-20378385
ABSTRACT
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.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
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Antirreumáticos
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Síndrome de Ativação Macrofágica
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Leishmaniose Visceral
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Anticorpos Monoclonais
Limite:
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Joint Bone Spine
Assunto da revista:
REUMATOLOGIA
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
Espanha