Visceral Leishmaniasis in a Rheumatoid Arthritis Patient Receiving Methotrexate

Visceral Leishmaniasis in the Mediterranean area

“…Trigkidis et al (1) mentioned that only eight cases of this condition have been reported so far. We would like to highlight that our group reported a similar case that was recently published elsewhere, increasing the number of cases to nine (2). The onset of VL can be silent or full-blown (kala-azar), with its characteristic pentad: prolonged fever, weight loss, hepatosplenomegaly, pancytopenia, and hypergammaglobulinemia.…”

“…To sum up, we are glad to add another case of VL, specifying that in the Mediterranean area, L. infantum is the major subtype that infects patient with RA as an opportunistic germen, not predictable with pharmacogenetic analyses to date (2). Moreover, we want to point out that MTX plays a role in the host defense, but we wonder what is the role deserved to the concomitant use of steroids in decreasing cellular host Letter to the Editor…”

Case Report: Cutaneous Leishmaniasis in a Rheumatoid Arthritis Patient Receiving Methotrexate

“…Patients are generally treated with MTX, but despite being effective at controlling disease, its use is often accompanied by serious adverse effects, including hematotoxicity, which can develop in up to 15% of RA patients. 19,20 The identification of Leishmania DNA in blood sample indicates parasite dissemination. 21 Diagnostic tests for the visceral leishmaniasis form must be highly sensitive and exact because of the high risk of mortality associated with the disease.…”