Histoplasmosis is a rare fungal infection more commonly seen in people with poorly functioning immune systems such as people with AIDS, those receiving strong chemotherapy and those taking other medications which can alter immune function. Typically, histoplasmosis causes flu-like symptoms with cough and in some patients skin lesions such as ulcerations. Because it is an uncommon ailment, diagnosis is often delayed allowing the disease to progress to an advanced state.
In September 2008, the FDA ordered the makers of 4 biologic drugs to include a specific warning about the increased risk of histoplasmosis in patients taking these drugs. The drugs included in the warning are Enbrel, Remicade, Humira and Cimzia (the first three are used for both arthritis and psoriasis, the last one is used for Crohn's disease). So far, 240 cases of histoplasmosis have been diagnosed in patients using these drugs. Of these patients, at least 21 had a delayed diagosis and 12 of them died. Even with timely diagnosis the disease is dangerous: 45 people out of the 240 infected died.
What does this mean for you?
If you are currently being treated with one of these biologic drugs and you develop symptoms such as persistent fever, cough, shortness of breath and fatigue, you should contact you doctor and perhaps express your concerns about the possibility of histoplasmosis so that this diagnosis will not be overlooked.
Source: Information for Cimzia (certolizumab pegol), Enbrel(etanercept), Humira (adalimumab), and Remicaide (infliximabe) U.S. Food and Drug Administration Center for Drug Evaluation and Research FDA Alert 9/4/08.
