1st Department of Internal Medicine, Evangelismos Hospital, Athens, Greece.
J Clin Rheumatol. 2010 Jan;16(1):38-9. doi: 10.1097/RHU.0b013e3181c8aa33.
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.
肿瘤坏死因子-α（TNF-α）是一种细胞因子，与许多炎症性疾病的发病机制以及针对感染的免疫介导反应有关，尤其是针对细胞内病原体。TNF-α拮抗剂的出现代表了结缔组织疾病（如类风湿关节炎）治疗的一场革命。然而，这些药物的使用与越来越多的机会性感染的出现有关。在这里，我们报告了一例内脏利什曼病，患者为 77 岁女性，先前曾因类风湿关节炎接受英夫利昔单抗治疗。强调了该患者的非典型表现，先前曾接受过抗 TNF-α生物制剂治疗，未发现脾肿大或肝肿大。
