Fulminant Legionellosis in Two Patients Treated with Infliximab for Crohn’s Disease: Case Series and Literature Review
TLDR
Two cases of fulminant pulmonary legionellosis are described, complicated by prolonged intensive care unit stays and acute respiratory distress syndrome, and who were recently treated with infliximab for Crohn's disease, and Physicians prescribing anti-TNF-alpha drugs should be aware of this association.Abstract:
Two cases of fulminant pulmonary legionellosis, complicated by prolonged intensive care unit stays and acute respiratory distress syndrome, and who were recently treated with infliximab for Crohn’s disease, are described. A review of the literature revealed three additional cases in patients with inflammatory bowel disease, and a total of 22 cases of Legionella pneumophila pneumonia in the context of treatment with antitumour necrosis (TNF)-alpha medications. The median age of the patients was 49 years, and men and women were affected equally. The case fatality rate was 14% (three of 22). Early recognition and treatment of this anti-TNF-alpha-related complication would likely result in reduced mortality and morbidity. Physicians prescribing anti-TNF-alpha drugs should be aware of this association.read more
Citations
More filters
Journal ArticleDOI
TNF and TNF-receptors: From mediators of cell death and inflammation to therapeutic giants – past, present and future
TL;DR: The therapeutic modulation of TNF now moves into the era of personalized medicine with society's challenging expectations of durable treatment success and of achieving long-term disease remission.
Journal ArticleDOI
Opportunistic infections and biologic therapies in immune-mediated inflammatory diseases: consensus recommendations for infection reporting during clinical trials and postmarketing surveillance
Kevin L. Winthrop,Shannon A. Novosad,John W. Baddley,L. Calabrese,Tom Chiller,Philip M. Polgreen,F Bartalesi,Marc Lipman,Xavier Mariette,Olivier Lortholary,Michael E. Weinblatt,Michael S. Saag,Josef S Smolen +12 more
TL;DR: The consensus group developed a working definition for OIs as ‘indicator’ infections, defined as specific pathogens or presentations of pathogens that ’indicate’ the likelihood of an alteration in host immunity in the setting of biologic therapy.
Journal ArticleDOI
Incidence and Risk Factors of Legionella pneumophila Pneumonia During Anti-Tumor Necrosis Factor Therapy: A Prospective French Study
Fanny Lanternier,Florence Tubach,Florence Tubach,Philppe Ravaud,Dominique Salmon,Pierre Dellamonica,Stéphane Bretagne,Marie Couret,Béatrice Bouvard,Michel Debandt,Isabelle Gueit,Jean-Pierre Gendre,Jean Leone,Nathalie Nicolas,Dider Che,Xavier Mariette,Xavier Mariette,Olivier Lortholary +17 more
TL;DR: The incidence and risk factors of legionellosis associated with tumor necrosis factor (TNF)-α antagonist use are described and the risk is higher for patients receiving anti-TNF-α monoclonal antibodies than soluble TNF-receptor therapy.
Journal ArticleDOI
Legionella pneumophila Type II Secretion Dampens the Cytokine Response of Infected Macrophages and Epithelia
Kessler McCoy-Simandle,Catherine R. Stewart,Jenny Dao,Sruti DebRoy,Ombeline Rossier,Paul J. Bryce,Nicholas P. Cianciotto +6 more
TL;DR: The impact of T2S on lung infection is a combination of at least three factors: the promotion of growth in macrophages, the facilitation ofrowth in epithelia, and the dampening of the chemokine and cytokine output from infected host cells.
Journal ArticleDOI
Crohn’s disease as an immunodeficiency
TL;DR: The pathogenesis of Crohn’s disease has been regarded as the consequence of a dysregulated T-cell-mediated response to intestinal microbes, but recent molecular biological and clinical investigations indicate that CD is actually a primary immunodeficiency.
References
More filters
Journal ArticleDOI
A case of legionellosis during treatment with a TNFα antagonist
TL;DR: Arguments are discussed for an emerging incidence of infections with intracellular microorganisms, granulomatous and non-granulOMatous, in patients having received anti-TNFα therapy.
Journal ArticleDOI
Severe Legionella pneumophila pneumonia following infliximab therapy in a patient with Crohn's disease
Florian Beigel,Matthias Jürgens,Levent Filik,Lutz Bader,Christian Lück,Burkhard Göke,Thomas Ochsenkühn,Stephan Brand,Julia Seiderer +8 more
TL;DR: The case of a 58‐year‐old patient with Crohn's disease treated with steroids and azathioprine who developed severe Legionella pneumophila pneumonia after 3 infusions of infliximab is reported.
Journal ArticleDOI
Pneumonitis caused by Legionella pneumoniae in a patient with rheumatoid arthritis treated with anti-TNF-alpha therapy (infliximab).
TL;DR: This is the first report of Legionella pneumoniae (LP) infection during TNFinhibitor treatment, and there is reason to be concerned about the relation between TNFblockers and the development of opportunistic infections that FDA reports suggest more likely under infliximab therapy than under etanercept treatment.
Journal ArticleDOI
Fatal fulminant legionnaires' disease in a patient with severe erythodermic psoriasis treated with infliximab after long-term steroid therapy.
Klaus Eisendle,Peter O. Fritsch +1 more
TL;DR: 1 Orecchia G, Douville H, Santagostino I et al.