Cerebral toxoplasmosis associated with treatment with rituximab, azathioprine and prednisone for dermatomyositis

Br J Clin Pharmacol. 2021 Mar;87(3):1525-1528. doi: 10.1111/bcp.14445. Epub 2020 Aug 3.

Abstract

We observed a severe case of cerebral toxoplasmosis in a 22-year-old woman diagnosed with dermatomyositis in 2016 in Venezuela, and treated with rituximab and azathioprine. The patient met clinical and microbiological criteria. Treatment with pyrimethamine and sulfadiazine was initiated, and the patient was discharged. She was rehospitalized with signs and symptoms of a manic episode. During hospitalization, the patient developed acute kidney injury related to sulfadiazine crystalluria. Finally, acute kidney injury was resolved and the patient was successfully discharged.

Keywords: adverse drug reactions; azathioprine; cerebral toxoplasmosis; immunosuppression; medication errors; patient safety; rituximab.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Azathioprine / adverse effects
  • Dermatomyositis* / drug therapy
  • Drug Therapy, Combination
  • Female
  • Humans
  • Prednisone / adverse effects
  • Rituximab / adverse effects
  • Toxoplasmosis, Cerebral* / drug therapy
  • Young Adult

Substances

  • Rituximab
  • Azathioprine
  • Prednisone