Cutaneous leishmaniasis associated with TNF-α blockers: a case report

• Published in: European journal of hospital pharmacy. Science and practice 2019-07, Vol.26 (4), p.233-234
• Main Authors: Nieto Gómez, Pelayo, Casas Hidalgo, Inmaculada, Casas Hidalgo, María de la Paz, Álvarez Sánchez, Raquel, Rodríguez Delgado, Alejandro, Cabeza-Barrera, Jose
• Format: Article
• Language: English
• Subjects: anti-tnf; Arthritis; Case Report; Case reports; Cell adhesion & migration; Drug stores; Hepatitis; Immune system; immunosuppression; Immunotherapy; Infections; Infectious diseases; infliximab; leishmaniasis; Monoclonal antibodies; Parasitic diseases; Patients; Pharmacists; Protozoa; psoriatic arthritis; Rheumatology; TNF inhibitors; Tuberculosis; Tumor necrosis factor-TNF
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2018-001521

Leishmaniasis is a chronic protozoan disease that is found in diverse geographical areas of the world. Leishmania 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 Leishmania spp. In this case report we describe Leishmania 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.