Sinus aspergilloma in rheumatoid arthritis before or during tumor necrosis factor-alpha antagonist therapy
Sinus aspergilloma in rheumatoid arthritis before or during tumor necrosis factor-alpha antagonist therapy
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肿瘤坏死因子-α拮抗剂治疗前或治疗期间类风湿性关节炎中的窦曲菌瘤
DOI：
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发表时间：
2009
影响因子：
4.9
通讯作者：
F. Lioté
中科院分区：
文献类型：
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作者：
A. Leboime;J. Berthelot;Y. Allanore;Lama Khalil;P. Herman;P. Orcel;F. Lioté
2008年，美国食品药品监督管理局要求TNFα拮抗剂生产商加强对类风湿关节炎（RA）患者严重真菌感染风险的警告。鼻窦曲菌瘤偶尔发生在类风湿关节炎患者，并可进展为侵袭性曲霉病。本研究的目的是描述有症状的窦曲菌瘤在RA患者治疗TNFα antagonists.MethodsRetrospective描述性研究的症状性窦曲菌瘤的病例RA患者在三个法国大学医院。A systematic literature reviewed.ResultsAmong 550 RA patients treated with TNFα antagonists，six（1.1%）had symptomatic上颌曲菌球CT诊断之前或期间TNFα antagonists治疗。无慢性中性粒细胞减少症。所有6例患者均采用手术治疗。在文献中，我们发现了20例慢性炎症性关节疾病患者（包括10例RA患者）曲霉菌感染的报告。仅5/20例患者接受TNFα拮抗剂治疗（侵袭性肺曲霉菌病，n = 3;颅内曲霉菌病，n = 1;蝶窦炎，n = 1）。在开始或转换TNFα拮抗剂之前，应考虑进行鼻窦常规计算机断层扫描。
IntroductionIn 2008, the Food and Drugs Administration required manufacturers of TNFα antagonists to strengthen their warnings about the risk of serious fungal infections in patients with rheumatoid arthritis (RA). Sinus aspergilloma occurs occasionally in RA patients and can progress to invasive Aspergillus disease. The purpose of this study was to describe symptomatic sinus aspergilloma in RA patients treated with TNFα antagonists.MethodsRetrospective descriptive study of symptomatic cases of sinus aspergilloma in patients with RA followed in three French university hospitals. A systematic literature review was performed.ResultsAmong 550 RA patients treated with TNFα antagonists, six (1.1%) had symptomatic maxillary aspergilloma diagnosed by computed tomography before or during TNFα antagonist therapy. None had chronic neutropenia. Aspergilloma treatment was with surgery only in all six patients. In the literature, we found 20 reports of Aspergillus infection in patients with chronic inflammatory joint diseases (including 10 with RA). Only 5/20 patients were treated with TNFα antagonists (invasive lung aspergillosis, n = 3; intracranial aspergillosis, n = 1; and sphenoidal sinusitis, n = 1).ConclusionsOtorhinolaryngological symptoms must be evaluated before starting or switching TNFα antagonists. Routine computed tomography of the sinuses before starting or switching TNFα antagonists may deserve consideration.
影响因子：
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作者：
Doran, MF;Crowson, CS;Gabriel, SE
通讯作者：
Gabriel, SE