Nieto Gómez Pelayo, Casas Hidalgo Inmaculada, Casas Hidalgo María de la Paz, Álvarez Sánchez Raquel, Rodríguez Delgado Alejandro, Cabeza-Barrera Jose
Farmacia Hospitalaria, Hospital Universitario San Cecilio, Granada, Spain.
Servicio de Microbiología y Parasitología, Hospital Universitario San Cecilio, Granada, Spain.
Eur J Hosp Pharm. 2019 Jul;26(4):233-234. doi: 10.1136/ejhpharm-2018-001521. Epub 2018 May 5.
Leishmaniasis is a chronic protozoan disease that is found in diverse geographical areas of the world. spp. are endemic in the Mediterranean coasts of southern Europe. Tumour necrosis factor alpha (TNF-α) plays an important role in the defence of the host against infection by spp. In this case report we describe infection caused by a monoclonal antibody against TNF-α: infliximab. A 51-year-old patient with psoriatic arthritis treated with infliximab, 5 mg/kg every 6 weeks as immunomodulatory treatment and methotrexate 10 mg weekly as a conventional disease-modifying antirheumatic drug, visited his otorhinolaryngologist owing to a lesion in his left nostril. The lesion was diagnosed as cutaneous leishmaniasis so treatment with infliximab was suspended. The patient was then treated with liposomal amphotericin B and showed a total recovery of the lesion; liposomal amphotericin B was maintained at 5 mg/kg monthly.
利什曼病是一种慢性原生动物疾病，在世界不同地理区域均有发现。在地中海沿岸的南欧地区有多种利什曼原虫属物种为地方病。肿瘤坏死因子α（TNF-α）在宿主抵御利什曼原虫属物种感染的过程中发挥着重要作用。在本病例报告中，我们描述了一例由抗TNF-α单克隆抗体英夫利昔单抗引发的感染。一名51岁的银屑病关节炎患者接受英夫利昔单抗治疗，每6周注射5mg/kg作为免疫调节治疗，同时每周服用10mg甲氨蝶呤作为传统的病情改善抗风湿药物。由于左侧鼻孔出现病变，该患者前往耳鼻喉科医生处就诊。该病变被诊断为皮肤利什曼病，因此暂停了英夫利昔单抗治疗。随后，该患者接受了脂质体两性霉素B治疗，病变完全康复；脂质体两性霉素B维持剂量为每月5mg/kg。
