Efraín Guillermo Sánchez1, David Acosta2, Juan Álvarez2, Gabriela Sánchez2, Julio García-Casallas3. 1. Departamento de Medicina Interna, Fundación Cardioinfantil - Universidad del Rosario, Bogotá, D.C., Colombia. biomedica@ins.gov.co. 2. Clínica Universidad de La Sabana, Universidad de La Sabana, Chía, Colombia. biomedica@ins.gov.co. 3. Clínica Universidad de La Sabana, Universidad de La Sabana, Chía, Colombia; Grupo de investigación Evidencia Terapéutica, Facultad de Medicina, Universidad de La Sabana, Chía, Colombia. julio.garcia@unisabana.edu.co.
Abstract
Introduction: Multiple adverse effects have been described for the biological therapy in autoimmune diseases including many secondary to immunosuppression producing bacterial, fungal, or viral infections. Clinical case: We present the case of a 64-year-old female patient with proven disseminated cryptococcosis secondary to the use of tofacitinib. Other possible causes of immunosuppression such as the human immunodeficiency virus (HIV) were ruled out. The patient had been in treatment for rheumatoid arthritis diagnosed three years before. This drug is a biological agent that inhibits JAK enzymes. Very few cases of pulmonary and meningeal cryptococcosis in this type of patient have been described in the literature. Conclusion: This case report should be useful for other clinicians to bear in mind the possibility of this type of invasive fungal infection associated with biological therapy and to take a risk-management approach.
Introduction: Multiple adverse effects have been described for the biological therapy in autoimmune diseases including many secondary to immunosuppression producing bacterial, fungal, or viral infections. Clinical case: We present the case of a 64-year-old female patient with proven disseminated cryptococcosis secondary to the use of tofacitinib. Other possible causes of immunosuppression such as the human immunodeficiency virus (HIV) were ruled out. The patient had been in treatment for rheumatoid arthritis diagnosed three years before. This drug is a biological agent that inhibits JAK enzymes. Very few cases of pulmonary and meningeal cryptococcosis in this type of patient have been described in the literature. Conclusion: This case report should be useful for other clinicians to bear in mind the possibility of this type of invasive fungal infection associated with biological therapy and to take a risk-management approach.
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