Histoplasmosis in a child with JRA on low-dose methotrexate |
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| Authors: | Hunstad D A French A R |
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| Affiliation: | Division of Infectious Diseases and 1Division of Immunology and Rheumatology, Department of Pediatrics, Washington University School of Medicine, St Louis, MO 63110, USA. |
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| Abstract: | SIR, Patients receiving immunosuppressive agents are at riskfor opportunistic infections (OIs), highlighted by recent reportsof tuberculous and fungal infections in patients receiving anti-TNF therapy. OIs are rare in children receiving low-dose methotrexate,despite its frequent use in the management of rheumatologicalconditions. We present a case of histoplasmosis in a child withpolyarticular juvenile rheumatoid arthritis (JRA) receivinglow-dose methotrexate. A 7-yr-old Missouri female presented with diffuse joint complaintsand morning stiffness. She had synovitis with decreased rangeof motion in |
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