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Clinical aspects and management of cutaneous leishmaniasis in rheumatoid patients treated with TNF-α antagonists

2013; Elsevier BV; Volume: 11; Issue: 6 Linguagem: Inglês

10.1016/j.tmaid.2013.05.003

1873-0442

Andreas Neumayr, Gloria Morizot, Leo G. Visser, Diana N. J. Lockwood, Bernhard Beck, Stefan Schneider, G. Bellaud, F. Cordoliani, F. Foulet, Emmanuel Laffitte, Pierre Buffet, Johannes Blum,

Hepatitis Viruses Studies and Epidemiology

Patients under immunosuppressive therapy with tumor necrosis factor alpha (TNF-α) antagonists are vulnerable to various opportunistic infections including leishmaniasis. We present a case series of 8 travellers developing cutaneous leishmaniasis whilst on TNF-α antagonist treatment and review the literature on aspects of cutaneous leishmaniasis developing in patients treated with TNF-α antagonists. We make interim recommendations regarding the drug therapy used to maintain remission in travellers with rheumatoid disease travelling to leishmania prone areas. Despite having a medical condition requiring continued rheumatological review the interval to diagnosis appears not to be reduced compared to that described in non-rheumatoid patients. Rheumatologists and family doctors should be aware of the need for post-travel surveillance for leishmaniasis in rheumatoid patients on TNF-alpha antagonist treatment.