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Journal Articles PLoS Neglected Tropical Diseases Year : 2022

Toxoplasmosis in patients with an autoimmune disease and immunosuppressive agents: A multicenter study and literature review

1 Hôpital Dupuytren [CHU Limoges]
2 APHM - Assistance Publique - Hôpitaux de Marseille
3 KSAU-HS - King Saud Bin Abdulaziz University for Health Sciences [Riyadh]
4 Service de Parasitologie Mycologie [CHU Limoges]
5 IAB - Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble)
6 CHU Pitié-Salpêtrière [AP-HP]
7 SU - Sorbonne Université
8 CHU Rouen
9 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
10 ABTE - Aliments Bioprocédés Toxicologie Environnements
11 Service de Microbiologie [CHU Caen]
12 Hôpital universitaire Robert Debré [Reims]
13 ESCAPE - Epidémiosurveillance de protozooses à transmission alimentaire et vectorielle
14 Service des Agents Infectieux et Hygiène [CHU Saint-Etienne]
15 Service de Parasitologie-Mycologie [CHRU LIlle]
16 VITROME - Vecteurs - Infections tropicales et méditerranéennes
17 IHU Marseille - Institut Hospitalier Universitaire Méditerranée Infection
18 Hôpital Pellegrin
19 Remington Laboratory for Specialty Diagnostics
20 Laboratoire de Parasitologie-Mycologie, Nice
21 C3M - Centre méditerranéen de médecine moléculaire
22 GREYC - Groupe de Recherche en Informatique, Image et Instrumentation de Caen
23 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
24 Irset - Institut de recherche en santé, environnement et travail
25 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
26 Hôpital Cochin [AP-HP]
27 UNILIM - Université de Limoges
28 CHU Limoges
Gilles Gargala
  • Function : Author
Estelle Cateau
  • Function : Author

Abstract

Background Cases of Toxoplasma reactivation or more severe primary infection have been reported in patients receiving immunosuppressive (IS) treatment for autoimmune diseases (AID). The purpose of this study was to describe features of toxoplasmosis occurring in patients with AID treated by IS therapy, excluded HIV-positive and transplant patients. Methods A multicenter descriptive study was conducted using data from the French National Reference Center for Toxoplasmosis (NRCT) that received DNA extracts or strains isolated from patients, associated with clinical data. Other cases were retrieved through a questionnaire sent to all French parasitology and internal medicine departments. Furthermore, a systematic literature review was conducted. Results 61 cases were collected: 25 retrieved by the NRCT and by a call for observations and 36 from a literature review. Half of the cases were attributed to reactivation (50.9%), and most of cases (49.2%) were cerebral toxoplasmosis. The most common associated AID were rheumatoid arthritis (28%) and most frequent treatments were antimetabolites (44.3%). Corticosteroids were involved in 60.7% of cases. Patients had a favorable outcome (50.8%) but nine did not survive. For 12 cases, a successful Toxoplasma strain characterization suggested the possible role of this parasitic factor in ocular cases. Conclusion Although this remains a rare condition, clinicians should be aware for the management of patients and for the choice of IS treatment.
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hal-03996340 , version 1 (22-02-2024)

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Marie-Fleur Durieux, Jean-Guillaume Lopez, Maher Banjari, Karine Passebosc-Faure, Marie-Pierre Brenier-Pinchart, et al.. Toxoplasmosis in patients with an autoimmune disease and immunosuppressive agents: A multicenter study and literature review. PLoS Neglected Tropical Diseases, 2022, 16 (8), pp.e0010691. ⟨10.1371/journal.pntd.0010691⟩. ⟨hal-03996340⟩
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