Clinical Rheumatology

, Volume 26, Issue 8, pp 1344–1345 | Cite as

Visceral leishmaniasis infection in a patient with rheumatoid arthritis treated with etanercept

  • V. BagalasEmail author
  • I. Kioumis
  • P. Argyropoulou
  • D. Patakas
Case Report


Visceral leishmaniasis (VL) is a severe disease that can develop in immunocompromised patients. Antitumor necrosis factor-α (TNF-α) treatment of rheumatoid arthritis can result in clinical benefits, but with an increased risk of opportunistic infections. Leishmania infection in patients treated with TNF-α antagonists is extremely rare; for this reason, we report a patient with VL after etanercept treatment who had an unfavorable outcome.


Etanercept Rheumatoid arthritis TNF-α antagonists Visceral leishmaniasis 


  1. 1.
    YT Konttinen et al (2005) Management of rheumatic diseases in the era of biological anti-rheumatic drugs. Acta Orthop 76:614–619PubMedCrossRefGoogle Scholar
  2. 2.
    Berman JD (1997) Human leishmaniasis: clinical, diagnostic, and chemotherapeutic developments in the last 10 years. Clin Infect Dis 24:684–703 (Apr)PubMedGoogle Scholar
  3. 3.
    Ho JL et al (1994) Cytokines in the treatment of leishmaniasis: from studies of immunopathology to patient therapy. Biotherapy 7:223–235PubMedCrossRefGoogle Scholar
  4. 4.
    Green SJ et al (1990) Activated macrophages destroy intracellular Leishmania major amastigotes by an L-arginine-dependent killing mechanism. J Immunol 144:278–283 (Jan 1)PubMedGoogle Scholar
  5. 5.
    Tak PP et al (1996) Decrease in cellularity and expression of adhesion molecules by anti-tumor necrosis factor alpha monoclonal antibody treatment in patients with rheumatoid arthritis. Arthritis Rheum 39:1077–1081 (Jul)PubMedCrossRefGoogle Scholar
  6. 6.
    Paleolog EM, Fava RA (1998) Angiogenesis in rheumatoid arthritis: implications for future therapeutic strategies. Springer Semin Immunopathol 20:73–94PubMedCrossRefGoogle Scholar
  7. 7.
    Rosenthal E et al (1995) Visceral leishmaniasis and HIV-1 co-infection in southern France. Trans R Soc Trop Med Hyg 89:159–162 (Mar–Apr)PubMedCrossRefGoogle Scholar
  8. 8.
    Baixauli Rubio A et al (2003) Rare opportunistic disease in a patient treated with immunosuppressive therapy for rheumatoid arthritis (in Spanish). An Med Interna 20:276–277 (May)PubMedGoogle Scholar
  9. 9.
    Wallis RS et al (2004) Granulomatous infections due to tumor necrosis factor blockade: correction. Clin Infect Dis 39:1254–1255 (Oct 15)PubMedCrossRefGoogle Scholar
  10. 10.
    Fabre S et al (2005) Visceral leishmaniasis infection in a rheumatoid arthritis patient treated with infliximab. Clin Exp Rheumatol 23:891–892 (Nov–Dec)PubMedGoogle Scholar

Copyright information

© Clinical Rheumatology 2006

Authors and Affiliations

  • V. Bagalas
    • 1
    Email author
  • I. Kioumis
    • 1
  • P. Argyropoulou
    • 1
  • D. Patakas
    • 1
  1. 1.Department of Pulmonary DiseaseAristotle University of Thessaloniki Medical School–“G. Papanikolaou” HospitalExohiGreece

Personalised recommendations