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Palacios-Diaz RD, Sahuquillo-Torralba A, Rocamora-Durán V, Unamuno-Bustos BD, Salavert-Lleti M, Santos-Alarcón S, Quintero A, Garcías-Ladaria J, Vila-Payeras A, Martínez-Doménech A, Mateu-Puchades A, Nadal-Lladó C, Botella-Estrada R. Klinisch-pathologische Eigenschaften kutaner und mukokutaner Leishmaniose bei mit TNF-α-Inhibitoren behandelten Patienten. J Dtsch Dermatol Ges 2023; 21:473-481. [PMID: 37183744 DOI: 10.1111/ddg.15007_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 01/03/2023] [Indexed: 05/16/2023]
Affiliation(s)
| | | | | | | | - Miguel Salavert-Lleti
- Infectious Diseases Department, Hospital Universitario y Politécnico La Fe, Valencia, Spanien
| | | | - Adriana Quintero
- Pathology Department, Hospital de Manacor, Illes Baleares, Spanien
| | - Joan Garcías-Ladaria
- Dermatology Department, Hospital Universitario Son Espases, Illes Baleares, Spanien
| | - Aina Vila-Payeras
- Dermatology Department, Hospital Universitario Son Llàtzer, Palma de Mallorca, Illes Baleares, Spanien
| | | | | | - Cristina Nadal-Lladó
- Dermatology Department, Hospital Universitario Son Llàtzer, Palma de Mallorca, Illes Baleares, Spanien
| | - Rafael Botella-Estrada
- Dermatology Department, Hospital Universitario y Politécnico La Fe, Valencia, Spanien
- Department of Medicine, Universitat de València, Valencia, Spanien
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Shu Kurizky P, Dos Santos Neto LL, Barbosa Aires R, Henrique da Mota LM, Martins Gomes C. Opportunistic tropical infections in immunosuppressed patients. Best Pract Res Clin Rheumatol 2020; 34:101509. [PMID: 32299676 DOI: 10.1016/j.berh.2020.101509] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Autoimmune and autoinflammatory diseases are associated with severe morbidity, and represent an impactful health and economic burden worldwide. The treatment of these diseases can include a course with detrimental side effects. Immunosuppression increases the risk of opportunistic infections, but in some cases, the abrupt discontinuation of these medications can result in immune reconstitution inflammatory syndrome. Special attention must be directed to endemic tropical infections, such as leishmaniasis, Chagas disease, malaria, arbovirosis, yellow fever, leprosy, paracoccidioidomycosis, disseminated strongyloidiasis, and ectoparasitosis. These endemic diseases of developing countries can be considered as possible emerging diseases in developed regions partially because of environmental factors and migration. In the present article, we aim to review the evidence-based aspects of the most important opportunistic tropical infections in immunosuppressed patients. We also aim to review the important aspects of vaccination, chemical prophylaxis, and treatment for these infections in people with medication-induced immunosuppression.
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Affiliation(s)
- Patrícia Shu Kurizky
- Programa de Pós-graduação em Ciências Médicas, Hospital Universitário de Brasília, SGAN 605. Av. L2 Norte, CEP: 70910-900, Brasília, Distrito Federal, Brazil.
| | - Leopoldo Luiz Dos Santos Neto
- Programa de Pós-graduação em Ciências Médicas, SGAN 605. Av. L2 Norte, CEP: 70910-900, Brasília, Distrito Federal, Brazil.
| | - Rodrigo Barbosa Aires
- Programa de Pós-graduação em Ciências Médicas, SGAN 605. Av. L2 Norte, CEP: 70910-900, Brasília, Distrito Federal, Brazil.
| | - Licia Maria Henrique da Mota
- Programa de Pós-graduação em Ciências Médicas, Hospital Universitário de Brasília, SGAN 605. Av. L2 Norte, CEP: 70910-900, Brasília, Distrito Federal, Brazil.
| | - Ciro Martins Gomes
- Programa de Pós-graduação em Ciências Médicas, Programa de Pós-Graduação em Medicina Tropical, SGAN 605. Av. L2 Norte, CEP: 70910-900, Brasília, Distrito Federal, Brazil.
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Kurizky PS, Marianelli FF, Cesetti MV, Damiani G, Sampaio RNR, Gonçalves LMT, de Sousa CAF, Martins SS, Vernal S, da Mota LMH, Gomes CM. A comprehensive systematic review of leishmaniasis in patients undergoing drug-induced immunosuppression for the treatment of dermatological, rheumatological and gastroenterological diseases. Rev Inst Med Trop Sao Paulo 2020; 62:e28. [PMID: 32401957 PMCID: PMC7232954 DOI: 10.1590/s1678-9946202062028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/17/2020] [Indexed: 04/06/2023] Open
Abstract
Immunosuppression is an important risk factor for leishmaniasis. We assessed the clinical profile, geographic distribution and prevalence of leishmaniasis in patients undergoing immunosuppressive therapy for dermatological, rheumatological or gastroenterological autoimmune diseases. We identified relevant studies in PubMed, EMBASE, Scopus, Web of Science and LILACS on July 3rd, 2018. We included articles that reported at least one case of leishmaniasis in patients undergoing immunosuppressive treatment for dermatological, rheumatological or gastroenterological diseases. Our protocol was registered in PROSPERO (CRD42018103050). We assessed the quality of the included studies with the Joanna Briggs Institute Critical Appraisal Tool. After the removal of duplicates, 5,431 articles were collected and screened. We included 138 articles; the prevalence of leishmaniasis in six methodologically similar studies varied from three to 1,282 cases per 100,000 patients using anti-TNFα drugs, but the results were significantly heterogeneous . Leishmaniasis in patients treated with immunosuppressive drugs is a health problem mostly reported in European countries bordering the Mediterranean Sea; sporadic activities, such as travelling, seem not to be associated with a significant risk of leishmaniasis, although effective control measures must always be observed.
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Affiliation(s)
- Patrícia Shu Kurizky
- Universidade de Brasília, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Médicas, Brasília, Brazil
- Hospital Universitário de Brasília, Brasília, Brazil
- Universidade de Brasília, Faculdade de Medicina, Grupo de Diagnóstico Dermatológico, Brasília, Brazil
- Universidade de Brasília, Faculdade de Medicina, Laboratório de Dermatomicologia, Brasília, Brazil
| | | | - Mariana Vicente Cesetti
- Universidade de Brasília, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Médicas, Brasília, Brazil
| | - Giovanni Damiani
- Case Western Reserve University, Department of Dermatology, Cleveland, Ohio, USA
- IRCCS Istituto Ortopedico Galeazzi, Dermatologia Clinica, Milan, Italy
- Università degli Studi di Milano, Dipartimento di Scienze Biomediche, Chirurgiche e Odontoiatriche, Milan, Italy
| | - Raimunda Nonata Ribeiro Sampaio
- Universidade de Brasília, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Médicas, Brasília, Brazil
- Universidade de Brasília, Faculdade de Medicina, Grupo de Diagnóstico Dermatológico, Brasília, Brazil
- Universidade de Brasília, Faculdade de Medicina, Laboratório de Dermatomicologia, Brasília, Brazil
- Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, Brasília, Brazil
| | | | | | - Sofia Sales Martins
- Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, Brasília, Brazil
| | - Sebastian Vernal
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Clínica Médica, Programa de Pós-Graduação em Clínica Médica, Ribeirão Preto, São Paulo, Brazil
| | - Licia Maria Henrique da Mota
- Universidade de Brasília, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Médicas, Brasília, Brazil
- Hospital Universitário de Brasília, Brasília, Brazil
| | - Ciro Martins Gomes
- Universidade de Brasília, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Médicas, Brasília, Brazil
- Hospital Universitário de Brasília, Brasília, Brazil
- Universidade de Brasília, Faculdade de Medicina, Grupo de Diagnóstico Dermatológico, Brasília, Brazil
- Universidade de Brasília, Faculdade de Medicina, Laboratório de Dermatomicologia, Brasília, Brazil
- Universidade de Brasília, Faculdade de Medicina, Núcleo de Medicina Tropical, Programa de Pós-Graduação em Medicina Tropical, Brasília, Brazil
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Gianchecchi E, Montomoli E. The enemy at home: leishmaniasis in the Mediterranean basin, Italy on the focus. Expert Rev Anti Infect Ther 2020; 18:563-577. [DOI: 10.1080/14787210.2020.1751611] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
| | - Emanuele Montomoli
- VisMederi S.r.l, Siena, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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Muslimani MA, Di Palma-Grisi J. Severe acute toxoplasmosis infection following ustekinumab treatment in a patient with psoriasis vulgaris. BMJ Case Rep 2019; 12:12/8/e230415. [PMID: 31420435 DOI: 10.1136/bcr-2019-230415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
A 26-year-old man undergoing therapy with 45 mg ustekinumab (Stelara) for chronic psoriasis vulgaris was referred by his general practitioner to an infectious diseases department for fatigue, fever, night sweating, generalised lymphadenomegaly and unexplained weight loss. Physical examination revealed bilateral occipital, cervical, axillary and inguinal lymphadenomegalies in addition to splenomegaly. Preliminary investigation revealed elevated Plasmodium lactate dehydrogenase and an inversion of the CD4/CD8 ratio. Whole-body spiral CT scanning with and without contrast showed splenomegaly and highlighted supradiaphragmatic and subdiaphragmatic lymphadenopathies. A complete Infectious Disease Test Panel revealed high levels of anti-Toxoplasma gondii antibodies. Immunoglobulin G avidity was negative. Peripheral blood lymphocyte phenotyping was performed to exclude underlying lymphatic neoplasia. The diagnosis of severe acute toxoplasmosis infection in the setting of immune response modifiers was made. Ustekinumab was suspended indefinitely and the patient underwent monthly serological tests to monitor the immune response until all symptoms resolved and the serological testing was negative for Toxoplasma.
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Affiliation(s)
- Muhammad A Muslimani
- Facolta di Medicina, Universita degli Studi di Pavia Facolta di Medicina e Chirurgia, Pavia, Lombardia, Italy
| | - James Di Palma-Grisi
- Facolta di Medicina, Universita degli Studi di Pavia Facolta di Medicina e Chirurgia, Pavia, Lombardia, Italy
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