Infliximab is a monoclonal antibody to tumor necrosis factor alpha (TNF-alpha). A patient treated with infliximab may be at increased risk for cutaneous or visceral leishmaniasis.


Risk for leishmaniasis:

(1) A person living or traveling to a region endemic for visceral or cutaneous leishmaniasis.

(2) A person with a history of visceral or cutaneous leishmaniasis.

(3) The presence of other factors impairing host defenses (immunosuppression, malnutrition, etc).


A patient at risk should be monitored for leishmaniasis. PCR-RFLP analysis can help make the diagnosis in biopsy specimens.


If leishmaniasis occurs then:

(1) therapy with anti-leishmanial drugs may allow continued infliximab therapy

(2) infliximab therapy may need to be stopped if all else fails.


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