RESUMO
BACKGROUND: Biologic therapies are widely used in inflammatory diseases, and they are associated to an increased infection risk, especially to granulomatous and intracellular infections such as Legionella. RESULTS: A review of the literature revealed 105 cases of Legionella pneumonia in patients taking biologic therapies. Sixty-four patients (65.3%) were treated with infliximab, 23 (23.5%) with adalimumab, 5 (5%) with etanercept and 3 (3%) with rituximab. Seventy-one per cent of the patients were treated for rheumatologic diseases and 16% for inflammatory bowel diseases. The majority of the patients received one or more concomitant immunosuppressive drugs, especially steroids (43%). Overall mortality was 19%. Legionella pneumonia might complicate therapy with biologic therapies, especially in patients being treated with infliximab or adalimumab given concomitantly with other immunosuppressive medications during their first 6 months of treatment. CONCLUSION: Physicians should be aware of this potentially severe association. Early recognition and treatment would likely result in reduced morbidity and mortality.
Assuntos
Fatores Biológicos/efeitos adversos , Terapia Biológica/efeitos adversos , Legionelose/induzido quimicamente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais/efeitos adversos , Feminino , Humanos , Doenças Inflamatórias Intestinais/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Doenças Reumáticas/tratamento farmacológicoRESUMO
El abatacept es un nuevo fármaco disponible para el tratamiento de los pacientes con artritis reumatoide (AR) refractaria. No obstante, al igual que sucede con otros tratamientos biológicos, este tratamiento no está exento de potenciales efectos adversos. A continuación se presenta el caso de una paciente de 73 años, con AR tratada con abatacept, en el que se desarrolló neumonía por Legionella pneumophila tipo 1 (AU)
Abatacept is a new drug available for refractory Rheumatoid Arthritis (RA), as other biologic therapies this drug is not free of potentially serious adverse events. We present a case of a 73 year-old patient treated with abatacept who suffered a Legionella pneumophila type 1 pneumoniae (AU)
Assuntos
Humanos , Feminino , Idoso , Artrite Reumatoide/tratamento farmacológico , Anticorpos Monoclonais/efeitos adversos , Legionelose/induzido quimicamente , Fatores de Necrose Tumoral/antagonistas & inibidores , Legionella/patogenicidadeRESUMO
Adalimumab, etanercept and infliximab: long-term monitoring is required.
