Development of leprosy in a patient with ankylosing spondylitis during the infliximab treatment: reactivation of a latent infection?

Lopes, Roberta Vilela; Ohashi, Claudia Barros; Cavaleiro, Luíza Helena dos Santos; Cruz, Rosana de Britto Pereira; Veiga, Rossana Ruth Garcia da; Miranda, Milton Edson; Yoshikawa, Gilberto Toshimitsu

doi:10.1007/s10067-009-1140-0

Cited by 21 publications

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“…It was shown that the surface proteins ESAT-6 and CFP-10 used in the QTF test are also present in M. leprae [17]. Moreover, reactivation of leprosy was reported in three patients who were using TNF-α antagonists [18-20]. However, the QTF test had not been studied among patients with leprosy.…”

Section: Introductionmentioning

confidence: 99%

Quantiferon-TB Gold in tube assay for the screening of tuberculosis before and during treatment with tumor necrosis factor alpha antagonists

et al. 2012

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IntroductionThe usefulness of interferon-gamma (IFN-γ) release assays for tuberculosis screening before tumor necrosis factor-alpha (TNF-α) antagonists and for monitoring during treatment is a contraversial issue. The aims of this study were to determine whether TNF-α antagonists affect the results of the Quantiferon-TB Gold in-tube assay (QTF); to assess how QTF performs in comparison with the tuberculin skin test (TST) in rheumatoid arthritis (RA) patients who are about to start treatment with TNF-α antagonists, RA patients who are not candidates for treatment with TNF-α antagonists, rheumatology patients with confirmed current or past tuberculosis infection, and healthy controls, and to determine the specificity of the QTF test to differentiate leprosy patients, another group of patients infected with mycobacteria.MethodsThe 38 RA patients who were prescribed TNF-α antagonists, 40 RA patients who were not considered for TNF-α antagonist use, 30 rheumatology patients with a history or new diagnosis of tuberculosis, 23 leprosy patients, and 41 healthy controls were studied. QTF and TST were done on the same day, and both were repeated after a mean of 3.6 ± 0.2 months in patients who used TNF-α antagonists.ResultsTreatment with TNF-α antagonists did not cause a significant change in the QTF or TST positivity rate (34% versus 42%; P = 0.64; and 24% versus 37%; P = 0.22). Patients with leprosy had a trend for a higher mean IFN-γ level (7.3 ± 8.0) and QTF positivity (61%) than did the other groups; however, the difference was not significant (P = 0.09 and P = 0.43).ConclusionsTreatment with TNF-α antagonists does not seem to affect the QTF test to an appreciable degree. The higher IFN-γ levels in leprosy patients deserves further attention.

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Section: Introductionmentioning

confidence: 99%

Quantiferon-TB Gold in tube assay for the screening of tuberculosis before and during treatment with tumor necrosis factor alpha antagonists

et al. 2012

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“…Several case reports and case series have described new development, reactivation, worsening, or accelerated progression of leprosy, with or without leprosy reactions, in patients exposed to biologics (such as infliximab, adalimumab, etanercept, and abatacept) for the treatment of different inflammatory immunemediated diseases, such as RA, ankylosing spondylitis, psoriatic arthritis, and psoriasis (84)(85)(86)(87)(88)(89). Usually, the biologic was discontinued after the diagnosis, but in some cases, it was reinstituted after the completion of anti-leprosy multi-drug therapy.…”

Section: Leprosy and Immunobiologics Therapymentioning

confidence: 99%

New insights at the interface between leprosy and immune-mediated rheumatic diseases

Cruz,

Albuquerque,

Guimarães

et al. 2023

Front. Med.

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Leprosy is an infectious and contagious disease of slow evolution, triggered by Mycobacterium leprae. Arthritis is its third most common manifestation, after cutaneous and peripheral nerve involvement. Since musculoskeletal symptoms may be the initial presentation of the disease, it is important for health professionals to recognize its rheumatic manifestations for early diagnosis and appropriate treatment, especially in endemic areas. In addition, cases of leprosy have increased globally, notably in patients undergoing treatment with TNF-α blockers and due to the increase in migration and travel of people from developing countries to developed countries. This review proposes to discuss the main scenarios of mimicry of different rheumatic diseases by leprosy, as well as the role of immunosuppressive drugs used in rheumatology practice in the treatment of reactional states and in the risk of developing the infection.

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Current awareness: Pharmacoepidemiology and drug safety

2009

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 23 sections: 1 Reviews; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Teratogens/fetal exposure; 20 Antidiabetic Agents; 21 Contrast Agents; 22 Bone Conservation Agents; 23 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Development of leprosy in a patient with ankylosing spondylitis during the infliximab treatment: reactivation of a latent infection?

Cited by 21 publications

References 11 publications

Quantiferon-TB Gold in tube assay for the screening of tuberculosis before and during treatment with tumor necrosis factor alpha antagonists

Quantiferon-TB Gold in tube assay for the screening of tuberculosis before and during treatment with tumor necrosis factor alpha antagonists

New insights at the interface between leprosy and immune-mediated rheumatic diseases

Current awareness: Pharmacoepidemiology and drug safety

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