Care against infections in rheumatic autoimmune diseases

In this issue we have two articles of great interest to the clinical practice of Rheumatology as well as other specialties. Designed primarily for members of the Commissions of Epidemiology and Rheumatoid Arthritis of the Brazilian Society of Rheumatology (SBR), they present a consensus of specialists based on a literature review.

The first article is a review of Braz et al.¹ on the treatment of intestinal parasites in patients with autoimmune rheumatic diseases, which addresses the situations of immunosuppression risk often experienced. This is an article that discusses a topic that has not received due importance, both in scientific media and in the daily practice of rheumatologists, who strive to prevent viral and bacterial infections and tuberculosis, often neglecting parasitic infections. Perhaps this occurs in face of the shortage of reports of serious infections by these agents. On the other hand, the authors comment on the high morbidity and mortality of such infections in this population, which serves as a basis for prescribing treatment and prophylactic drug interventions.

The second article is a positioning from Mota et al.² in face of the unavailability of the tuberculin skin test (PPD), the recommended tool in the evaluation and treatment of latent tuberculosis in patients with rheumatoid arthritis. The lack of reagent for the test, reported by the Ministry of Health, has brought growing impact from the second half of 2014, causing concern both for physicians and patients and also delays in the prescribing and dispensing of biologicals, as well as prescriptions without the recommended care. Here the authors show how the physician should proceed in this context and highlight the importance of provision of interferon gamma release assays, tests known as IGRA (interferon-γ release assays), to optimize the evaluation and prescription of these drugs, particularly for candidates for the use of anti-TNF drugs.

• DOIs of original articles: http://dx.doi.org/10.1016/j.rbre.2015.01.006, http://dx.doi.org/10.1016/j.rbre.2014.10.010

REFERÊNCIAS

• ¹
  Braz AS, Andrade CA, Mota LM, Lima CM. Recomendações da Sociedade Brasileira de Reumatologia sobre Diagnóstico e Tratamento das Parasitoses Intestinais em Pacientes com Doenças Reumáticas Autoimunes. Rev Bras Reumatol. 2015;55:368–80.
• ²
  Mota LM, Cruz BA, Albuquerque CP, Gonçalves D, Laurindo IM, Pereira IA, et al. Orientações preliminares da Sociedade Brasileira de Reumatologia para avaliação e tratamento da tuberculose infecção latente em pacientes com artrite reumatoide, na indisponibilidade do teste tuberculínico. Rev Bras Reumatol. 2015;55:390–3.

Publication Dates

• Publication in this collection
  Jul-Aug 2015