Visceral leishmaniasis and anti-TNF-α therapy:case report and review of the literature

Clinical and Experimental Rheumatology

F. De Leonardis¹  M. Govoni¹  A. Lo Monaco¹  F. Trotta¹ 

关键词: Visceral leishmaniasis;    opportunistic infection;    tumour necrosis factor-α;    biologic therapy;    autoimmune disease.;   

DOI  :  

学科分类：医学（综合）

来源: Pacini Editore SpA

【 摘 要 】

OBJECTIVES:Visceral leishmaniasis (VL) is an extremely rare example of opportunistic infection in patients treated with TNF-α 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.CONCLUSIONS: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.

【 授权许可】

Unknown