<http://lib.bioinfo.pl/auth:Salata,RA>

J Infect. 2007 Oct 5; : 17920687 (P,S,E,B,D)

Mycobacterium other than tuberculosis (MOTT) infection: An emerging
disease in infliximab-treated patients.

Edsel Maurice T Salvana, Gregory S Cooper, Robert A Salata

OBJECTIVES: Infliximab has revolutionized treatment of rheumatologic
diseases and inflammatory bowel disease. However, it increases the risk of
tuberculosis. Less is known about the development of Mycobacterium other
than tuberculosis (MOTT) infection. We review the literature on
non-tuberculous mycobacterial infections in infliximab-treated patients
and report the first case of disseminated Mycobacterium avium complex in
an infliximab-treated patient complicated by immune reconstitution
inflammatory syndrome. METHODS AND RESULTS: MEDLINE search with the
keywords mycobacteria and infliximab revealed four cases of MOTT in
patients treated with infliximab: fatal Mycobacterium peregrinum pneumonia
in a patient with polymyositis and dermatomyositis; a patient with
rheumatoid arthritis with skin and soft tissue infection with
Mycobacterium abscessus; Mycobacterium fortuitum in a patient with
rheumatoid arthritis; and a case of pulmonary MAC without dissemination.
Review of US data from 1998 to 2002 published by Wallis et al. revealed
that out of more than 233,000 patients treated with infliximab, 30
developed unspecified mycobacterial species infection. No further data was
available regarding these cases. CONCLUSION: MOTT infection is a rare but
emerging complication of infliximab therapy. MOTT cases tend to progress
rapidly in infliximab-treated patients and withdrawal of infliximab
therapy can result in immune reconstitution.
--
Dale
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He who oppresses the poor to increase his wealth and he who gives gifts to
the rich—both come to poverty.
-- Proverbs 22:16