Kesteman Thomas, Yombi Jean-Cyr, Gigi Jacques, Durez Patrick
Microbiology Department, Cliniques universitaires Saint-Luc, Université catholique de Louvain, MBLG 54.92, Avenue Hippocrate, 54, 1200, Brussels, Belgium.
Infectious diseases Department, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
Clin Rheumatol. 2007 Dec;26(12):2173-2175. doi: 10.1007/s10067-007-0660-8. Epub 2007 Jun 20.
Infliximab is a human-murine chimeric monoclonal antibody directed against tumor necrosis factor alpha (TNFalpha). Infliximab and other TNF blockers are used to treat inflammatory diseases such as rheumatoid arthritis (RA). TNF blockers are suspected to play a key role in some infections. We report here two cases of Listeria monocytogenes sepsis associated with infliximab treatment for RA. The first patient developed a terminal ileitis and a bacteraemia after three doses of infliximab; the second RA patient presented a bacteraemia associated with a prosthetic joint arthritis of the left hip, both related to Listeria. Those two cases occurred in a population of 518 patients treated with TNF blockers in our hospitals since the year 2000. Those events are of particular interest because of the severity of the infection, because the treatment differs from other infections, and because that, in the rheumatology unit, septic arthritis can mimic RA symptoms. They enhance the likelihood for this drug to increase the risk for infections with germs like Listeria.
英夫利昔单抗是一种针对肿瘤坏死因子α（TNFα）的人鼠嵌合单克隆抗体。英夫利昔单抗和其他TNF阻滞剂用于治疗类风湿关节炎（RA）等炎症性疾病。TNF阻滞剂被怀疑在某些感染中起关键作用。我们在此报告两例与英夫利昔单抗治疗RA相关的单核细胞增生李斯特菌败血症病例。首例患者在接受三剂英夫利昔单抗治疗后发生了末端回肠炎和菌血症；第二例RA患者出现了与左髋关节人工关节关节炎相关的菌血症，两者均与李斯特菌有关。自2000年以来，在我们医院接受TNF阻滞剂治疗的518例患者中发生了这两例病例。由于感染的严重性、治疗方法与其他感染不同，以及在风湿病科中，化脓性关节炎可模仿RA症状，这些事件特别引人关注。它们增加了这种药物增加感染李斯特菌等病菌风险的可能性。
