Adalimumab
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Reactions 1462, p7 - 27 Jul 2013 S Adalimumab Fatal relapsing Legionella pneumophila pneumonia in an elderly patient: case report A 78-year-old woman developed fatal relapsing Legionella pneumophila pneumonia during adalimumab treatment. The woman had a 14-year history of rheumatoid arthritis, and due to persistently high disease activity, was stated on adalimumab 40mg injections [frequency not stated]. Eight days after her second adalimumab injection, she presented with fatigue, a fever of 38.6 °C and bloody sputum for 2 days. She was admitted to hospital, where coarse crackles were heard in the right lower lung, and hypoxaemia was observed on oxygen monitoring. A urine L. pneumophila antigen test was positive. Chest x-ray revealed a permeation shadow in the right lower lung, and a chest CT scan showed pleural thickening, light ground glass opacities under the pleura, and consolidation on the right. She was given a clinical diagnosis of L. pneumophila pneumonia, and started on pazufloxacin. She exhibited a remarkable recovery and was discharged on day 10. Seroconversion of L. pneumophila was subsequently confirmed, as was complete resolution of pneumonia via chest CT scan. However, on day 55 her pneumonia relapsed, with a new finding of deep mycosis and interstitial pneumonia. She received numerous treatments, but died of aggravated interstitial pneumonia on day 79. Author comment: "We report a rare case of pneumonia caused by L. pneumophila in an RA patient after only two [adalimumab] injections. The patient had initially recovered from the infection but later died because of relapse". Hayashi M, et al. A fatal case of relapsing pneumonia caused by Legionella pneumophila in a patient with rheumatoid arthritis after two injections of adalimumab. Clinical Medicine Insights: Case Reports 6: 101-106, 2013. Available from: URL: http://dx.doi.org/10.4137/CCRep.S11641 - Japan 803090399 1 Reactions 27 Jul 2013 No. 1462 0114-9954/13/1462-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved
Transcript of Adalimumab
Reactions 1462, p7 - 27 Jul 2013
SAdalimumab
Fatal relapsing Legionella pneumophila pneumoniain an elderly patient: case report
A 78-year-old woman developed fatal relapsing Legionellapneumophila pneumonia during adalimumab treatment.
The woman had a 14-year history of rheumatoid arthritis,and due to persistently high disease activity, was stated onadalimumab 40mg injections [frequency not stated]. Eight daysafter her second adalimumab injection, she presented withfatigue, a fever of 38.6 °C and bloody sputum for 2 days. Shewas admitted to hospital, where coarse crackles were heard inthe right lower lung, and hypoxaemia was observed on oxygenmonitoring. A urine L. pneumophila antigen test was positive.Chest x-ray revealed a permeation shadow in the right lowerlung, and a chest CT scan showed pleural thickening, lightground glass opacities under the pleura, and consolidation onthe right. She was given a clinical diagnosis of L. pneumophilapneumonia, and started on pazufloxacin. She exhibited aremarkable recovery and was discharged on day 10.Seroconversion of L. pneumophila was subsequentlyconfirmed, as was complete resolution of pneumonia via chestCT scan. However, on day 55 her pneumonia relapsed, with anew finding of deep mycosis and interstitial pneumonia. Shereceived numerous treatments, but died of aggravatedinterstitial pneumonia on day 79.
Author comment: "We report a rare case of pneumoniacaused by L. pneumophila in an RA patient after only two[adalimumab] injections. The patient had initially recoveredfrom the infection but later died because of relapse".Hayashi M, et al. A fatal case of relapsing pneumonia caused by Legionellapneumophila in a patient with rheumatoid arthritis after two injections ofadalimumab. Clinical Medicine Insights: Case Reports 6: 101-106, 2013. Availablefrom: URL: http://dx.doi.org/10.4137/CCRep.S11641 - Japan 803090399
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Reactions 27 Jul 2013 No. 14620114-9954/13/1462-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved
