A CASE REPORT OF CHRONIC NECROTISING ASPERGILLOSIS ON TOCILIZUMAB THERAPY
Keywords:
Rheumatoid arthritis, adalimumab, tocilizumab, chronic necrotizing aspergillosis
Abstract
A case report of 64 years old gentleman with underlying Rheumatoid arthritis (RA) which was resistant to disease-modifying antirheumatic drugs (DMARD); prednisolone, methotrexate, sulfasalazine, and hydroxychloroquine required adalimumab. He did not respond to adalimumab and tocilizumab was subsequently given. He however developed pulmonary symptoms of which further investigations revealed high suspicion of Chronic necrotizing aspergillosis. We discuss our challenges in managing this case.
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References
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2. Klarenbeek NB, Allaart CF, Kerstens PJ, et al. The BeSt story: on strategy trials in rheumatoid arthritis. Curr Opin Rheumatol 2009;21:291-8.
3. Singh JA, Wells GA, Christensen R, et al. Adverse effects of biologics: a network meta-analysis and Cochrane overview. Cochrane Database Syst Rev 2011:Cd008794.
4. Latgé J-P. Aspergillus fumigatus and Aspergillosis. Clinical Microbiology Reviews 1999;12:310-350.
5. Gaemperli A, Hauser T, Speck R. [Risk of infection during treatment with tumor necrosis factor-alpha inhibitors]. Z Rheumatol 2006;65:24-8, 30-1.
6. Ogata A, Hirano T, Hishitani Y, et al. Safety and efficacy of tocilizumab for the treatment of rheumatoid arthritis. Clin Med Insights Arthritis Musculoskelet Disord 2012;5:27-42.
7. Walsh TJ, Anaissie EJ, Denning DW, et al. Treatment of Aspergillosis: Clinical Practice Guidelines of the Infectious Diseases Society of America. Clinical Infectious Diseases 2008;46:327-360.
8. Wheat LJ, Walsh TJ. Diagnosis of invasive aspergillosis by galactomannan antigenemia detection using an enzyme immunoassay. Eur J Clin Microbiol Infect Dis 2008;27:245-51.
9. Blum U, Windfuhr M, Buitrago-Tellez C, et al. Invasive pulmonary aspergillosis. MRI, CT, and plain radiographic findings and their contribution for early diagnosis. Chest 1994;106:1156-61.
10. Herbrecht R, Patterson TF, Slavin MA, et al. Application of the 2008 Definitions for Invasive Fungal Diseases to the Trial Comparing Voriconazole Versus Amphotericin B for Therapy of Invasive Aspergillosis: A Collaborative Study of the Mycoses Study Group (MSG 05) and the European Organization for Research and Treatment of Cancer Infectious Diseases Group. Clin Infect Dis 2014.
How to Cite
1.
Wan Asyraf WZ, MS MS, R P, AH MF. A CASE REPORT OF CHRONIC NECROTISING ASPERGILLOSIS ON TOCILIZUMAB THERAPY. Med. res. chronicles [Internet]. 2015Jun.15 [cited 2024Dec.22];2(3):451-5. Available from: https://medrech.com/index.php/medrech/article/view/106
Section
Case Report
