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Rheumatology Advance Access originally published online on November 18, 2006
Rheumatology 2007 46(1):177-178; doi:10.1093/rheumatology/kel375
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Histoplasmosis in a child with JRA on low-dose methotrexate

D. A. Hunstad and A. R. French1

Division of Infectious Diseases and 1Division of Immunology and Rheumatology, Department of Pediatrics, Washington University School of Medicine, St Louis, MO 63110, USA.

Correspondence to: A. R. French, MD, PhD, Division of Immunology and Rheumatology, Department of Pediatrics, Washington University, One Children's Place, St Louis, MO 63110, USA. E-mail: french_a@kids.wustl.edu

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SIR, Patients receiving immunosuppressive agents are at risk for opportunistic infections (OIs), highlighted by recent reports of tuberculous and fungal infections in patients receiving anti-TNF{alpha} therapy. OIs are rare in children receiving low-dose methotrexate, despite its frequent use in the management of rheumatological conditions. We present a case of histoplasmosis in a child with polyarticular juvenile rheumatoid arthritis (JRA) receiving low-dose methotrexate.

A 7-yr-old Missouri female presented with diffuse joint complaints and morning stiffness. She had synovitis with decreased range of motion in . . . [Full Text of this Article]


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