Volume 15, Number 6—June 2009
Dispatch
Leishmaniasis, Autoimmune Rheumatic Disease, and Anti–Tumor Necrosis Factor Therapy, Europe
Ioannis D. Xynos, Maria G. Tektonidou, Dimitrios Pikazis, and Nikolaos V. Sipsas
Table
Detailed characteristics of 15 patients with autoimmune rheumatic disorders in whom leishmaniasis developed, Europe*
| Patient no. | Country | Age, y/sex | Disease | Anti-TNF treatment | Other immunosuppressive treatments | Form of Leishmania infection | Ref. | |||
|---|---|---|---|---|---|---|---|---|---|---|
| Agent | Duration, mo | Agent(s) | Duration, mo | |||||||
| 1 | France | 66/M | ANCA-associated vasculitis | NA | NA | Cyclophosphamide, methotrexate, corticosteroids | 120 | Visceral | (7) | |
| 2 | Israel | 56/M | Rheumatoid arthritis | NA | NA | Methotrexate, corticosteroids | 120 | Cutaneous | (8) | |
| 3 | Italy | 35/M | Behçet disease | NA | NA | Chlorambucil, corticosteroids | 36 | Visceral | (9) | |
| 4 | Spain | 50/M | Rheumatoid arthritis | NA | NA | Methotrexate, corticosteroids | 120 | Visceral | (10) | |
| 5 | Italy | 60/M | Polyarteritis nodosa | NA | NA | Cyclophosphamide, corticosteroids | 2 | Visceral | (11) | |
| 6 | Spain | 55/M | Psoriatic arthritis | Infliximab | 9 | No details given | 300 | Visceral | (2) | |
| 7 | Italy | 76/M | ANCA-associated vasculitis | NA | NA | Cyclophosphamide, corticosteroids | 36 | Visceral | (12) | |
| 8 | France | 53/F | Rheumatoid arthritis | Infliximab | 12 | Azathioprine, corticosteroids | 12 | Visceral | (3) | |
| 9 | Italy | 69/F | Rheumatoid arthritis | Adalimumab | 25 | Methotrexate, corticosteroids | 360 | Visceral | (4) | |
| 10 | Greece | 60/F | Rheumatoid arthritis | Etanercept | 18† | Cyclosporine, corticosteroids, anakinra | 96 | Visceral | (5) | |
| 11 | France | 9/F | Juvenile rheumatoid arthritis | NA | NA | Cyclosporine, methotrexate, corticosteroids, anakinra | 60 | Visceral | (13) | |
| 12 | Greece | 45/M | Psoriatic arthritis | Infliximab | 60 | Methotrexate, corticosteroids | 60 | Visceral | (6) | |
| 13 | Greece | 65/F | Rheumatoid arthritis | NA | NA | Methotrexate | 96 | Visceral | (14) | |
| 14 | Greece | 71/F | Giant cell arteritis | Infliximab | 24 | Methotrexate, corticosteroids | 24 | Visceral | This study | |
| 15 | Greece | 55/M | Ankylosing spondylitis | Infliximab | 12 | Methotrexate | 12 | Cutaneous | This study | |
*TNF, tumor necrosis factor; Ref., reference; ANCA, anti-neutrophil cytoplasmic antibody; NA, not applicable.
†All biologic treatments had been terminated 6 mo before leishmaniasis occurred.
