Pneumocystis carinii pneumonia in a patient on etanercept for psoriatic arthritis
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Pneumocystis carinii pneumonia (PCP) is a rare form of pneumonia associated with immune-suppression. It is common in patients with AIDS and with a CD4 count of less than 200 cells/mm3. We report a case of PCP secondary to immune-suppression in a 41-year-old man with psoriatic arthritis being treated with the immune-modulatory agent etanercept.
Diagnosis of PCP was made histologically using tissue obtained via transbronchial biopsy.
There was a good response to standard treatment with high-dose co-trimoxazole.
This report highlights a recognised but previously unreported complication of etanercept.
- The National Institute of Health-University of California Expert Panel for Corticosteroids as Adjunctive Therapy for Pneumocystis Pneumonia (1990) Consensus statement on the use of corticosteroids as adjunctive therapy for pneumocystis pneumonia in the acquired immunodeficiency syndrome. N Engl J Med 323:1500–1504 CrossRef
- Pareja JG, Garland R, Koziel H (1998) Use of adjunctive corticosteroids in severe adult non-HIV Pneumocystis carinii pneumonia. Chest 113:1215–1224 CrossRef
- Bakleh M, Tleyjeh I, Matteson EL, Osmon DR, Berbari EF (2005) Infectious complications of tumor necrosis factor-α antagonists. Int J Dermatol 44(6):443–448 CrossRef
- Weinblatt ME, Kremer JM, Bankhurst AD et al (1999) A trial of etanercept, a recombinant tumor necrosis factor receptor: Fc fusion protein, in patients with rheumatoid arthritis receiving methotrexate. N Engl J Med 340:253–259 CrossRef
- Olsen NJ, Stein CM (2004) New drugs for rheumatoid arthritis. N Engl J Med 350:2167–2179 CrossRef
- Oien KA, Black A, Hunter JA, Madhok R (1995) Pneumocystis carinii pneumonia in a patient with rheumatoid arthritis, not on immunosuppressive therapy and in the absence of human immunodeficiency virus infection. Br J Rheumatol 34:677–679 CrossRef
- Mori S, Imamura F, Kiyofuji C et al (2006) Pneumocystis jiroveci pneumonia in a patient with rheumatoid arthritis as a complication of treatment with infliximab, anti-tumour necrosis factor alpha neutralizing antibody. Mod Rheumatol 16(1):58–62 CrossRef
- Gruden JF, Huang L, Turner J et al (1997) High-resolution CT in the evaluation of clinically suspected Pneumocystis carinii pneumonia in AIDS patients with normal, equivocal, or nonspecific radiographic findings. AJR Am J Roentgenol 169:967–975
- Shelhamer JH, Gill VJ, Quinn TC et al (1996) The laboratory evaluation of opportunistic pulmonary infections. Ann Intern Med 124:585–599
- Saito K, Nakayamada S, Nakano K et al (2004) Detection of Pneumocystis carinii by DNA amplification in patients with connective tissue diseases: re-evaluation of clinical features of P. carinii pneumonia in rheumatic diseases. Rheumatology (Oxford) 43:479–485 CrossRef
- Navin R (2001) Effect of mutations in Pneumocystis carinii dihydropteroate synthase gene on outcome of Pneumocystis carinii pneumonia in patients with HIV-1: a prospective study. Lancet 358:545–549 CrossRef
- Krebs S, Gibbons RB (1996) Low-dose methotrexate as a risk factor for Pneumocystis carinii pneumonia. Mil Med 161(1):58–60
- Pneumocystis carinii pneumonia in a patient on etanercept for psoriatic arthritis
Irish Journal of Medical Science
Volume 176, Issue 4 , pp 309-311
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Pneumocystis carinii
- Psoriatic arthritis
- Grocott’s silver stain
- Industry Sectors