Abstract
This is the first report of adalimumab-associated pulmonary cryptococcosis. A 56-year-old female with rheumatoid arthritis without a history of pulmonary disease was simultaneously administered adalimumab (40 mg/2 wks), methotrexate (4 mg/wk), and isoniazid (200 mg/day). Five months later, chest radiography revealed a small spiculated pulmonary nodule, and the laboratory test results, including levels of tumor markers and plasma β-D-glucan, were within normal ranges. Since the lesion continued to grow, even after discontinuing adalimumab, it was surgically resected. Grocott staining of the tissue sample revealed black-brown fungi, identified as Cryptococcus neoformans in culture. The patient now remains well, without adalimumab therapy.
Publication types
-
Case Reports
-
Research Support, Non-U.S. Gov't
MeSH terms
-
Adalimumab
-
Anti-Infective Agents / administration & dosage
-
Antibodies, Monoclonal, Humanized / administration & dosage
-
Antibodies, Monoclonal, Humanized / adverse effects*
-
Antirheumatic Agents / administration & dosage
-
Antirheumatic Agents / adverse effects*
-
Arthritis, Rheumatoid / drug therapy*
-
Cryptococcosis / chemically induced*
-
Cryptococcosis / diagnosis
-
Cryptococcosis / microbiology
-
Cryptococcosis / surgery
-
Cryptococcus neoformans / isolation & purification*
-
Drug Therapy, Combination
-
Female
-
Humans
-
Isoniazid / administration & dosage
-
Lung Diseases / chemically induced*
-
Lung Diseases / diagnosis
-
Lung Diseases / microbiology
-
Lung Diseases / surgery
-
Methotrexate / administration & dosage
-
Middle Aged
-
Thoracic Surgery, Video-Assisted
-
Tomography, X-Ray Computed
-
Treatment Outcome
Substances
-
Anti-Infective Agents
-
Antibodies, Monoclonal, Humanized
-
Antirheumatic Agents
-
Adalimumab
-
Isoniazid
-
Methotrexate