Histoplasmosis in Patients with Rheumatoid Arthritis
Author Information
Author(s): Timothy C Olson, Tim Bongartz, Cynthia S Crowson, Glenn D Roberts, Robert Orenstein, Eric L Matteson
Primary Institution: Mayo Clinic College of Medicine
Hypothesis
Are patients with rheumatoid arthritis at increased risk for histoplasmosis due to their immunosuppressive treatments?
Conclusion
Most patients with rheumatoid arthritis who developed histoplasmosis were on multiple immunomodulatory agents and had longstanding disease.
Supporting Evidence
- Histoplasmosis was diagnosed in 26 patients with rheumatoid arthritis.
- Most patients were on combination therapies including anti-TNF agents and corticosteroids.
- Fever was the most common clinical manifestation at presentation.
Takeaway
This study looked at people with rheumatoid arthritis who got a rare infection called histoplasmosis. Many of them were taking medicine that weakens their immune system.
Methodology
A retrospective review of medical records of RA patients diagnosed with histoplasmosis at Mayo Clinic from 1998 to 2009.
Potential Biases
Confounding variables and the endemic nature of histoplasmosis complicate attribution of specific therapies to infection risk.
Limitations
The study is limited by its small sample size and single-center design, which may not be generalizable.
Participant Demographics
15 males and 11 females, mean age 59.6 years, with a mean duration of RA of 10.5 years.
Digital Object Identifier (DOI)
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