Visceral leishmaniasis in a rheumatoid arthritis patient receiving methotrexate

Reumatol Clin. 2017 Nov-Dec;13(6):354-356. doi: 10.1016/j.reuma.2016.07.005. Epub 2016 Aug 11.
[Article in English, Spanish]

Abstract

Patients with rheumatoid arthritis (RA) treated with disease-modifying antirheumatic drugs are susceptible to severe infections such as leishmaniasis. As L. infantum is endemic in the Mediterranean region, it is necessary to rule this infectious process out in any RA patient presenting with fever and pancytopenia. An early diagnosis based on a high suspicion can prevent a fatal outcome.

Keywords: Artritis reumatoide; Kala-azar; Methotrexate; Metotrexato; Rheumatoid arthritis.

Publication types

  • Case Reports

MeSH terms

  • Amphotericin B / therapeutic use
  • Antiprotozoal Agents / therapeutic use
  • Arthritis, Rheumatoid / complications*
  • Arthritis, Rheumatoid / drug therapy
  • Disease Susceptibility
  • Early Diagnosis
  • Female
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Indomethacin / therapeutic use
  • Leishmaniasis, Visceral / diagnosis
  • Leishmaniasis, Visceral / drug therapy
  • Leishmaniasis, Visceral / etiology*
  • Methotrexate / adverse effects*
  • Methotrexate / therapeutic use
  • Middle Aged
  • Pancytopenia / chemically induced
  • Prednisone / adverse effects
  • Prednisone / therapeutic use

Substances

  • Antiprotozoal Agents
  • Immunosuppressive Agents
  • liposomal amphotericin B
  • Amphotericin B
  • Prednisone
  • Indomethacin
  • Methotrexate