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J Clin Rheumatol. 2010 Jan;16(1):38-9. doi: 10.1097/RHU.0b013e3181c8aa33.

An atypical presentation of visceral leishmaniasis infection in a patient with rheumatoid arthritis treated with infliximab.

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1st Department of Internal Medicine, Evangelismos Hospital, Athens, Greece.


Tumor necrosis factor alpha (TNF-alpha) is a cytokine, implicated in the pathogenesis of many inflammatory diseases, as well as in the immune-mediated response to infection, especially against intracellular pathogens. TNF-alpha antagonists have represented a revolution in the management of connective tissue diseases, such as rheumatoid arthritis. However, the use of these agents has been implicated with the emergence of a growing number of opportunistic infections. Here we report the case of a visceral Leishmaniasis in a 77-year-old woman who had been previously treated for rheumatoid arthritis with infliximab. The atypical presentation of this patient, previously treated with an anti-TNF-alpha biologic agent, where no splenomegaly or hepatomegaly was identified, is emphasized.

[Indexed for MEDLINE]

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