Asunto(s)
Adalimumab/efectos adversos , Azatioprina/efectos adversos , Coriorretinitis/inducido químicamente , Enfermedad de Crohn/tratamiento farmacológico , Inmunosupresores/efectos adversos , Toxoplasmosis Ocular/inducido químicamente , Adulto , Coroides/parasitología , Coroides/patología , Enfermedad de Crohn/parasitología , Femenino , Humanos , Ilustración Médica , Necrosis , Retina/parasitología , Retina/patologíaAsunto(s)
Azatioprina/efectos adversos , Colitis Ulcerosa/tratamiento farmacológico , Inmunosupresores/efectos adversos , Toxoplasmosis Ocular/inducido químicamente , Adulto , Antiinflamatorios no Esteroideos/uso terapéutico , Coriorretinitis/parasitología , Quimioterapia Combinada , Femenino , Humanos , Huésped Inmunocomprometido , Mesalamina/uso terapéutico , RecurrenciaRESUMEN
Paciente en tratamiento con sulfadiacina mas pirimetamina por toxoplasmosis oftálmica que desarrolla un cuadro de insuficiencia renal por depósito de cristales. Se observan al microscopio las imágenes características en gavilla de trigo de los cristales de sulfadiacina (AU)
A patient on treatment with sulfadiazine plus pyrimethamine for ophthalmic toxoplasmosis developed renal failure. Using a microscope it is possible to see the characteristic wheat sheaf images of the sulfadiazine crystals (AU)
Asunto(s)
Humanos , Masculino , Toxoplasmosis Ocular/inducido químicamente , Anticonvulsivantes/administración & dosificación , Anticonvulsivantes/efectos adversos , Sulfadiazina/uso terapéutico , Pirimetamina/uso terapéutico , Insuficiencia Renal/inducido químicamente , Insuficiencia Renal/complicaciones , Toxoplasmosis Ocular/complicaciones , Toxoplasmosis Ocular/diagnóstico , Insuficiencia Renal/terapia , Sulfadiazina/aislamiento & purificación , Sulfadiazina/toxicidadRESUMEN
OBJECTIVES: To present the data supporting the possible relationship of ocular toxoplasmosis to antitumor necrosis factor-alpha (TNF-alpha) therapy in patients with rheumatoid arthritis (RA). METHODS: A Medline search was performed using the words "toxoplasmosis, anti-TNF-alpha antagonists, chorioretinitis." We report 2 RA patients who developed ocular toxoplasmosis while receiving anti-TNF-alpha therapy. RESULTS: In addition to our patients with toxoplasmic chorioretinitis, there are 2 published cases of cerebral toxoplasmosis during treatment with anti-TNF-alpha agents. CONCLUSION: The risk of serious toxoplasmic infection during anti-TNF-alpha therapy for RA should be recognized.
Asunto(s)
Anticuerpos Monoclonales/efectos adversos , Antirreumáticos/efectos adversos , Artritis Reumatoide/tratamiento farmacológico , Toxoplasmosis Ocular/inducido químicamente , Adulto , Animales , Artritis Reumatoide/parasitología , Coriorretinitis/parasitología , Femenino , Humanos , Infliximab , Masculino , Toxoplasma , Factor de Necrosis Tumoral alfa/antagonistas & inhibidoresRESUMEN
PURPOSE: The authors discuss a possible relationship between systematic corticosteroid use and reactivation of ocular toxoplasmosis. METHODS: Patients were identified who developed foci of recurrent toxoplasmic retinochoroiditis while being treated with systemic corticosteroids. Case histories were reviewed retrospectively. RESULTS: During a 10-year interval, three patients were identified at the University of California, Los Angeles, who had been receiving systemic corticosteroid therapy (dose range, 0.27-1.23 mg/kg/day) when they developed recurrent toxoplasmic retinochoroiditis. Disease occurred at intervals of 20 days to approximately 1 year after start of corticosteroid therapy. Lesions were typical in appearance, course, and manner in which they responded to antimicrobial therapy. CONCLUSION: Recurrent toxoplasmosis in patients receiving corticosteroid therapy probably is uncommon. These cases do not confirm a causal relationship between corticosteroid use and initiation of disease recurrence.
