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Semin Arthritis Rheum ; 42(2): 127-30, 2012 Oct.
Article in English | MEDLINE | ID: mdl-22542278

ABSTRACT

BACKGROUND: Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disorder. There is a clear association between some disease-modifying drugs used to treat RA and infection. The introduction of the anti-tumor necrosis factor (TNF) therapies has improved the outcome of severe RA. The TNF-antagonism may increase susceptibility to granulomatous pathogens such as Mycobacterium tuberculosis, Listeria monocytogenes, and Histoplasma capsulatum. METHODS: We report the case of a 37-year-old woman with RA receiving an anti-TNF agent, who developed a rash on her back and both legs, which was finally diagnosed as tuberculoid leprosy. RESULTS: This is the first case of leprosy due to anti-TNF therapy reported in Europe. CONCLUSIONS: Clinicians should be aware of this and other types of atypical and serious infections that patients may suffer from when treated with anti-TNF agents.


Subject(s)
Antirheumatic Agents/adverse effects , Arthritis, Rheumatoid/drug therapy , Immunoglobulin G/adverse effects , Leprosy, Tuberculoid/etiology , Adult , Dapsone/therapeutic use , Drug Substitution , Etanercept , Female , Humans , Immunocompromised Host , Leprostatic Agents/therapeutic use , Leprosy, Tuberculoid/drug therapy , Receptors, Tumor Necrosis Factor , Treatment Outcome , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Withholding Treatment
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