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REVIEW  INFECTIOUS DISEASES AND CHEMOTHERAPY CONSEQUENCES: AN INVESTIGATION TO IMPROVE THE QUALITY OF LIFE IN PATIENTS 

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2018 October;177(10):548-55

DOI: 10.23736/S0393-3660.18.03817-2

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Leishmaniasis and biologic therapies for rheumatologic diseases: a concise review

Chiara IARIA 1 , Francesco SCARLATA 2, Valentina CAPUTO 3, Teresa REA 4, Nicola SERRA 4, Adriana CERVO 2, Davide MILILLI 2, Annamaria DE LUCA 2, Benedetta ROMANIN 2, Claudia COLOMBA 2

1 Infectious Diseases Unit -ARNAS Civico, Di Cristina, Benfratelli, Palermo, Italy; 2 Department of Health Promotion Sciences and Mother and Child Care “G. D’Alessandro”, University of Palermo, Palermo, Italy; 3 Dipartimento Biomedico di Medicina Interna e Specialistica (Di.Bi.Mi.S), Policlinico “Paolo Giaccone” University of Palermo, Palermo, Italy; 4 School of Medicine and Surgery, University Federico II of Naples, Naples, Italy


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INTRODUCTION: Leishmaniasis is a vector-borne protozoan infection whose clinical spectrum depends largely on parasite species and host immune response, ranging from asymptomatic infection to fatal visceral leishmaniasis. It is well known that tumour necrosis factor inhibitors may increase the risk of infections. However, there is scarce literature on Leishmania infections in patients treated with anti-TNF drugs to glean from the literature useful information about the background, the course, the clinical characteristics, the diagnostic issues raised, and the short- and long-term therapeutic approaches of leishmaniasis in patients in treatment with biologic drugs.
EVIDENCE ACQUISITION: A computerized search without language restriction was conducted using PubMed and SCOPUS. An article was considered eligible for inclusion in the review if it reported data on patients in treatment with biologic drugs who developed any form of leishmaniasis.
EVIDENCE SYNTHESIS: THIRTY-seven articles reporting 41 cases of leishmaniasis in patients in treatment with biologic drugs were finally considered. Most of the cases were acquired in Southern Europe. Twenty-three cases suffered from visceral leishmaniasis, and three of them died. In most of the cases the biological drugs involved were infliximab and adalimumab.
CONCLUSIONS: Visceral, cutaneous and mucocutaneous leishmaniasis should always be taken into consideration in patients under treatment with biological drugs and suffering from persistent fever or chronic cutaneous or mucocutaneous lesions in Countries in which the disease is endemic.


KEY WORDS: Leishmaniasis - Biological therapy - Rheumatology

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