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Volume 15, Number 6—June 2009


Leishmaniasis, Autoimmune Rheumatic Disease, and Anti–Tumor Necrosis Factor Therapy, Europe

Ioannis D. Xynos, Maria G. Tektonidou, Dimitrios Pikazis, and Nikolaos V. SipsasComments to Author 
Author affiliations: National and Kapodistrian University of Athens, Athens, Greece (I.D. Xynos, D. Pikazis, N.V. Sipsas); Euroclinic Hospital of Athens, Athens (M.G. Tektonidou)

Main Article


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
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.

Main Article