Visceral leishmaniasis in a patient treated with etanercept: Case repost
DOI:
https://doi.org/10.24950/rspmi.992Keywords:
visceral leishmaniasis, anti-TNF-alpha, Etanercept, rheumatoid arthritisAbstract
Visceral leishmaniasis is a systemic disease caused by protozoa, Leishmania. Published reports of visceral leishmaniasis
in patients treated with TNF-alpha inhibitors are very rare,
only eight, one of them on Etanercept. We report the case
of a 55-year-old woman, with previous conditions of severe
asthma, lung tuberculosis and recurrent respiratory tract infections. In 2006 she was diagnosed with alveolitis and later
in 2008 with rheumatoid arthritis. Due to worsening arthritis,
she began Etanercept in November 2009, with improvement.
About six months later, in May 2010, she was admitted due
to Morganella morganii pneumonia, also with pancitopenia
and relapsing arthritis. Bone marrow biopsy confirmed the
diagnosis of visceral leishmaniasis. The patient was treated
with liposomal Amphotericin B improving clinically. Careful
monitoring of patients on biological therapies demands a high
clinical suspicion to diagnose opportunistic infections that may
limit future therapeutic options.
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