Rheumatology International

, Volume 33, Issue 10, pp 2687–2689 | Cite as

Imported case of visceral leishmaniasis presenting as pancytopenia in a Norwegian patient treated with methotrexate and etanercept for psoriasis arthritis

  • Emilio BesadaEmail author
  • Rune Johan Njålla
  • Johannes C. Nossent
Short Communication


We report a case of visceral leishmaniasis in a patient from northern Norway with psoriatic arthritis treated with a combination of etanercept and methotrexate. The patient resided extensively in southern Spain, a zone endemic for leishmania.


Visceral leishmaniasis Etanercept Psoriasis arthritis Tumor necrosis factor-alpha Inhibitors Opportunistic infection 


Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Ready PD (2010) Leishmaniasis emergence in Europe. Euro Surveill 15(10):19505PubMedGoogle Scholar
  2. 2.
    Moral L, Rubio EM, Moya M (2002) A leishmanin skin test survey in the human population of l’Alacantí region (Spain): implications for the epidemiology of Leishmania infantum infection in southern Europe. Trans R Soc Trop Med Hyg 96:129–132PubMedCrossRefGoogle Scholar
  3. 3.
    Marty P, Izri A, Ozon C, Haas P, Rosenthal E, Del Giudice P et al (2007) A century of leishmaniasis in Alpes-Maritimes, France. Ann Trop Med Parasitol 101:563–574PubMedGoogle Scholar
  4. 4.
    Erre GL, Mesina P, Tonelli N, Passiu G (2010) Visceral leishmaniasis among immunosuppressed patients with rheumatic diseases. Clin Exp Rheumatol 28:590–591PubMedGoogle Scholar
  5. 5.
    Marty P, Pomares-Estran C, Hasseine L, Delaunay P, Haas H, Rosenthal E (2009) Leishmaniasis in France: an update. Arch Pediatr 16(Suppl 2):S96–S100PubMedCrossRefGoogle Scholar
  6. 6.
    Xynos ID, Tektonidou MG, Pikazis D, Sipsas NV (2009) Leishmaniasis, autoimmune rheumatic disease, and anti-tumor necrosis factor therapy, Europe. Emerg Infect Dis 15:956–959PubMedCrossRefGoogle Scholar
  7. 7.
    Malik ANJ, John L, Bryceson ADM, Lockwood DNJ (2006) Changing pattern of visceral leishmaniasis, United Kingdom, 1985–2004. Emerg Infect Dis 12:1257–1259PubMedCrossRefGoogle Scholar
  8. 8.
    De Leonardis F, Govoni M, Lo Monaco A, Trotta F (2009) Visceral leishmaniasis and anti-TNF-α therapy: case report and literature review. Clin Exp Rheumatol 27:503–506PubMedGoogle Scholar
  9. 9.
    Sakkas LI, Boulbou M, Kyriakou D, Makri I, Sinani C, Germenis A et al (2008) Immunological features of visceral leishmaniasis may mimic systemic lupus erythematosus. Clin Biochem 41:65–68PubMedCrossRefGoogle Scholar
  10. 10.
    Castellino G, Govoni M, Lo Monaco A, Montecucco C, Colombo F, Trotta F (2004) Visceral leishmaniasis complicating a connective tissue disease: three case reports from Italy. Lupus 13:201–203PubMedCrossRefGoogle Scholar
  11. 11.
    Viana RB, Neiva CL, Dias AF, do Rosario e Souza EF, de Padua PM (2010) Felty’s syndrome and Kala-azar: a challenge for the rheumatologist. Rev Bras Rheumatol 50:710–715CrossRefGoogle Scholar
  12. 12.
    Ahlin E, Elshafei A, Nur M, El Safi SH, Ronnelid J, Elghazali G (2011) Anti-citrullinated peptide antibodies and rheumatoid factor in Sudanese patients with Leishmania Donovani infection. Rev Bras Reumatol 51:572–586CrossRefGoogle Scholar
  13. 13.
    Rizos E, Dimos G, Liberopoulos EN, Elisaf MS, Drosos AA (2005) Cryoglobulinemic purpura in visceral leishmaniasis. Rheumatol Int 25:469–471PubMedCrossRefGoogle Scholar
  14. 14.
    Skram MK, Bjering S, Hermansen NO, Dini L, Hellebostad M (2011) En 15 gammel måneder jenta med feber og pancytopeni. Tidsskr Nor Legeforen 31:2482–2486CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Emilio Besada
    • 1
    Email author
  • Rune Johan Njålla
    • 2
  • Johannes C. Nossent
    • 1
  1. 1.University North NorwayTromsöNorway
  2. 2.Hospital of NordlandBodøNorway

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