Katagiri Akira, Ando Toshitaka, Kon Takayuki, Yamada Masato, Iida Noboru, Takasaki Yoshinari
Department of Internal Medicine and Rheumatology, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni-shi, Shizuoka, Japan.
Mod Rheumatol. 2008;18(3):285-9. doi: 10.1007/s10165-008-0039-y. Epub 2008 Feb 20.
We report a 35-year-old female patient with systemic lupus erythematosus (SLE). She was admitted due to deterioration of lupus nephritis and received treatment with a high dose of steroid and cyclosporine. Approximately 1 month after admission, the patient was also treated for cytomegalovirus (CMV) infection because she was found to have CMV antigenemia. Although a cavitary lesion was shown by chest computed tomography (CT), its cause could not be clarified by blood examination, smears or cultures, or by bronchoscopy. We considered that this lesion may have been caused by CMV pneumonitis because it was resolved during the treatment for CMV infection. It is known that CMV causes opportunistic infections in patients with collagen vascular diseases (CVD) who are receiving immunosuppressive therapy. However, it is extremely rare for a cavitary lesion to be formed as a result of CMV pneumonitis. Here we describe the details of this interesting case.
我们报告了一例35岁的系统性红斑狼疮（SLE）女性患者。她因狼疮性肾炎恶化入院，接受了大剂量类固醇和环孢素治疗。入院约1个月后，该患者因被发现患有巨细胞病毒（CMV）抗原血症而接受了CMV感染治疗。尽管胸部计算机断层扫描（CT）显示有空洞性病变，但通过血液检查、涂片或培养，或支气管镜检查均无法明确其病因。我们认为该病变可能是由CMV肺炎引起的，因为它在CMV感染治疗期间得到了缓解。众所周知，CMV会在接受免疫抑制治疗的胶原血管疾病（CVD）患者中引起机会性感染。然而，因CMV肺炎形成空洞性病变极为罕见。在此我们描述这一有趣病例的详细情况。
