Evidence map›Paper›PMID 42743917›Full record

ArticleThe American journal of tropical medicine and hygiene2026

Reactivation of Cutaneous Leishmaniasis in a Rheumatoid Arthritis Patient Undergoing Tocilizumab Treatment.

Regina Maia de Souza, Felipe Francisco Tuon, Antônio Carlos Nicodemo, Christini Takemi Emori, Beatriz Julieta Celeste, Maria Carmen Arroyo Sanchez, Valdir Sabbaga Amato

Abstract readCase Reports
In one paragraph

Article in The American journal of tropical medicine and hygiene, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

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No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Regina Maia de SouzaLaboratório de Parasitologia, São Paulo, Universidade de São Paulo Instituto de Medicina Tropical de São Paulo, São Paulo, Brazil.
Felipe Francisco TuonLaboratório de Doenças Infecciosas e Emergentes, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.
Antônio Carlos NicodemoFaculdade de Medicina, Departamento de Infectologia e Medicina Tropical, São Paulo, Universidade de São Paulo, São Paulo, Brazil.
Christini Takemi EmoriFaculdade de Medicina, Departamento de Infectologia e Medicina Tropical, São Paulo, Universidade de São Paulo, São Paulo, Brazil.
Beatriz Julieta CelesteLaboratório de Soroepidemiologia, São Paulo, Universidade de São Paulo Instituto de Medicina Tropical de São Paulo, São Paulo, Brazil.
Maria Carmen Arroyo SanchezLaboratório de Soroepidemiologia, São Paulo, Universidade de São Paulo Instituto de Medicina Tropical de São Paulo, São Paulo, Brazil.
Valdir Sabbaga AmatoLaboratório de Parasitologia, São Paulo, Universidade de São Paulo Instituto de Medicina Tropical de São Paulo, São Paulo, Brazil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Cutaneous leishmaniasis is a neglected vector-borne disease caused by Leishmania spp., with viable parasites potentially persisting after clinical cure. Immunosuppressive therapies may favor reactivation of latent infection. The case of a 62-year-old Brazilian woman with a 25-year history of rheumatoid arthritis who developed a painful ulcerative lesion on her right leg 1 month after initiating tocilizumab therapy is reported. Molecular testing confirmed Leishmania (Viannia) braziliensis, consistent with reactivated cutaneous leishmaniasis. Tocilizumab was discontinued, and liposomal amphotericin B was initiated but interrupted because of nephrotoxicity and hepatotoxicity. Despite incomplete treatment, the lesion gradually healed after withdrawal of immunosuppression without requiring additional antiparasitic therapy. Secondary prophylaxis with liposomal amphotericin B was subsequently initiated under close clinical and laboratory monitoring, and no recurrence has been observed during follow-up. This case highlights the importance of screening clinical history for prior leishmaniasis, maintaining vigilance for reactivation in patients from endemic areas, and promptly adjusting immunosuppressive therapy to optimize clinical outcomes.

Identifiers

PMID42743917
PMCPMC13590949

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.