Departamento de Medicina Interna, Fundación Cardioinfantil - Universidad del Rosario, Bogotá, D.C., Colombia.
Clínica Universidad de La Sabana, Universidad de La Sabana, Chía, Colombia.
Biomedica. 2022 Jun 1;42(2):218-223. doi: 10.7705/biomedica.6239.
Introduction: Multiple adverse effects have been described for the biological therapy in autoimmune diseases including many secondary to immunosuppression producing bacterial, fungal, or viral infections. Clinical case: We present the case of a 64-year-old female patient with proven disseminated cryptococcosis secondary to the use of tofacitinib. Other possible causes of immunosuppression such as the human immunodeficiency virus (HIV) were ruled out. The patient had been in treatment for rheumatoid arthritis diagnosed three years before. This drug is a biological agent that inhibits JAK enzymes. Very few cases of pulmonary and meningeal cryptococcosis in this type of patient have been described in the literature. Conclusion: This case report should be useful for other clinicians to bear in mind the possibility of this type of invasive fungal infection associated with biological therapy and to take a risk-management approach.
生物疗法在治疗自身免疫性疾病方面已经描述了多种不良反应，包括许多由于免疫抑制导致的细菌、真菌或病毒感染。
我们报告了一例 64 岁女性患者，因使用托法替布而继发播散性隐球菌病。排除了其他可能导致免疫抑制的原因，如人类免疫缺陷病毒 (HIV)。该患者三年前被诊断为类风湿关节炎，一直在接受治疗。该药物是一种抑制 JAK 酶的生物制剂。文献中很少有此类患者发生肺部和脑膜隐球菌病的报道。
本病例报告对于其他临床医生来说应该是有用的，让他们记住这种与生物治疗相关的侵袭性真菌感染的可能性，并采取风险管理方法。
