Toxoplasmic Chorioretinitis and Antitumor Necrosis Factor Treatment in Rheumatoid Arthritis

In vivo effect of anti-TNF agent (etanercept) in reactivation of latent toxoplasmosis

“…Young and McGwire (2005) have reported two cases of reactivation of cerebral toxoplasmosis while on treatment with infliximab. Lassoued et al (2007) have reported two cases of ocular toxoplasmosis in patients with rheumatoid arthritis receiving anti-TNF-a agent in patients, one of the two cases was because of reactivation of previous toxoplasmosis infection, whereas the other had primary acquired ocular toxoplasmosis. In addition, Gonzalez-Vicent et al (2003) reported a case of cerebral toxoplasmosis following etanercept treatment for idiopathic pneumonia syndrome after autologous peripheral blood progenitor cell transplantation.…”

“…It has been demonstrated to increase disease activity when administered to patients with opportunistic infections as toxoplasmosis and reactivation of latent tuberculosis (Sfikakis 2010). A few cases of cerebral toxoplasmosis and toxoplasmic chorioretinitis have been reported in patients who were treated with anti-TNF agents either etanercept or infliximab (Gonzalez-Vicent et al 2003;Lassoued et al 2007;Young and McGwire 2005). The aim of this study is to evaluate the effect of etanercept (TNF-a antagonist) in reactivation of latent toxoplasmosis compared to the therapeutic effect of sulfadiazine and pyrimethamine in combination on the progress of the disease.…”

Rapid progression of neurotoxoplasmosis in a patient with concomitant rheumatoid arthritis and systemic lupus erythematous

“…About one-third of the entire world population is infected with latent toxoplasmosis. [1][2][3][4][5][6] Central nervous system (CNS) toxoplasmosis occurs due to reactivation of previous latent infection. Patients usually present with fever, headache, impaired consciousness, seizures, and/ or focal neurological deficits.…”

“…Patients usually present with fever, headache, impaired consciousness, seizures, and/ or focal neurological deficits. [1][2][3][4][5] CNS toxoplasmosis may complicate the clinical course of patients with acquired human immunodeficiency (e.g. AIDS), immune system disease, or prolonged pharmacologic immunosuppressive treatment.…”

“…[1][2][3][4][5] Because the clinical picture and diagnosis are challenging, neurotoxoplasmosis may mimic several other CNS disorders, being especially difficult to manage and frequently requiring empiric treatment. [1][2][3][4][5] We present an unusual case of neurotoxoplasmosis developing in a patient with concomitant rheumatoid arthritis and systemic lupus erythematous (SLE).…”