Criptococosis diseminada por terapia biológica, se debe gestionar el riesgo.

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 cry...

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Published in:Biomédica: Revista del Instituto Nacional de Salud Vol. 42; no. 2; pp. 218 - 224
Main Authors: Guillermo Sánchez, Efraín, Acosta, David, Álvarez, Juan, Sánchez, Gabriela, García-Casallas, Julio
Format: Article
Published: Instituto Nacional de Salud of Colombia jun2022
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Online Access:View this record in EBSCOhost
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      dt: jun2022
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      pub: Instituto Nacional de Salud of Colombia
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        10.7705/biomedica.6239
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          Guillermo Sánchez, Efraín
          Acosta, David
          Álvarez, Juan
          Sánchez, Gabriela
          García-Casallas, Julio
        affil:
          Departamento de Medicina Interna, Fundación Cardioinfantil - Universidad del Rosario, Bogotá, D. C., Colombia
          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
      su:
        Biotherapy
        HIV
        Mycoses
        Virus diseases
        Cryptococcosis
        Autoimmune diseases
      sug:
        subj:
          Biotherapy
          HIV
          Mycoses
          Virus diseases
          Cryptococcosis
          Autoimmune diseases
      keyword:
        biological therapy
        cryptococcosis
        medication errors
        biological therapy
        criptococosis
        cryptococcosis
        Cryptococcus neoformans
        errores de medicación
        medication errors
        terapia biológica
      ab:
        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.
        Introducción. Se han descrito múltiples efectos adversos con el uso de la terapia biológica para enfermedades autoinmunitarias, muchos de ellos secundarios al estado de inmunosupresión, como las infecciones bacterianas, fúngicas o virales. Caso clínico. Se presenta el caso de una mujer de 64 años con diagnóstico comprobado de criptococosis diseminada secundaria al uso de tofacitinib. Se descartaron otras causas de inmunosupresión, como infección por el virus de la inmunodeficiencia humana (HIV). Tres años antes se le había diagnosticado artritis reumatoide y se encontraba en tratamiento farmacológico con un agente biológico que inhibe las enzimas JAK. Se han descrito muy pocos casos de criptococosis pulmonar y meníngea en este tipo de pacientes. Conclusión. Este reporte de caso es útil para que otros médicos tratantes tengan presente la posibilidad de este tipo de infección fúngica invasora asociada con la terapia biológica y el enfoque de gestión de riesgo.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: Spanish
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      custom: Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use.
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