An inconspicuous insect bite as the cause of sepsis in a patient treated with infliximab due to rheumatoid arthritis

Zynek-Litwin, M.; Kuźniar, J.; Noceń-Rychlewska, B.; Kusztal, M.; Klinger, M.
June 2011
Advances in Medical Sciences (De Gruyter Open);2011, Vol. 56 Issue 1, p106
Academic Journal
The monoclonal antibody against TNFa (infliximab) suppresses cytokines involved in inflammatory reaction. Consequently, infliximab is a potent agent in treating refractory rheumatoid arthritis (RA). There is also evidence showing beneficial anti-TNFα therapy effect on RA-related amyloidosis AA. TNFα inhibition may, however, lead to leucopenia and, eventually, severe sepsis. We discuss a case of RA with RA-related AA amyloidosis and renal impairment which was refractory to disease-modifying anti-rheumatic drug (DMARD). The treatment led to inflammatory complications of two distinct phases: immediately after drug administration and six weeks later. Both phases were linked to an innocuous skin infection.


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