Abstract
A 64-year-old woman with longstanding rheumatoid arthritis suffered from recurrent severe infections after treatment with both synthetic and biologic disease-modifying anti-rheumatic drugs (DMARDs). She was found to have mannose-binding lectin (MBL) deficiency. MBL deficiency is associated with increased risk of infections, in particular in individuals treated with immunomodulating drugs. Patients with a history of recurrent infections in childhood, and severe infections after treatment with synthetic or biologic DMARDs, should be tested for MBL deficiency.
MeSH terms
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Anti-Bacterial Agents / therapeutic use
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Antibodies, Monoclonal / adverse effects*
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Antirheumatic Agents / therapeutic use*
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Arthritis, Rheumatoid / complications
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Arthritis, Rheumatoid / drug therapy*
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Arthritis, Rheumatoid / immunology
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Bacterial Infections / complications
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Bacterial Infections / drug therapy*
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Bacterial Infections / immunology
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Contraindications
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Drug Therapy, Combination
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Female
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Glucocorticoids / therapeutic use
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Humans
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Immunocompromised Host*
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Immunologic Deficiency Syndromes*
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Immunologic Factors / adverse effects*
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Middle Aged
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Recurrence
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Synovitis / complications
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Synovitis / drug therapy
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Synovitis / immunology
Substances
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Anti-Bacterial Agents
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Antibodies, Monoclonal
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Antirheumatic Agents
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Glucocorticoids
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Immunologic Factors