巨细胞病毒感染在一名接受免疫抑制治疗的系统性红斑狼疮患者中表现为肺部空洞性病变。

CMV infection presenting as a cavitary lung lesion in a patient with systemic lupus erythematosus receiving immunosuppressive therapy.

作者信息

Azuma Naoto, Hashimoto Naoaki, Yasumitsu Akihiro, Fukuoka Kazuya, Yokoyama Kazunori, Sawada Hisashi, Nishioka Aki, Sekiguchi Masahiro, Kitano Masayasu, Kuroiwa Takanori, Matsui Kiyoshi, Sano Hajime

机构信息

Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya.

出版信息

Intern Med. 2009;48(24):2145-9. doi: 10.2169/internalmedicine.48.2495.

DOI:10.2169/internalmedicine.48.2495

PMID:20009410

Abstract

We report a case of cytomegalovirus (CMV) pneumonitis that presented as a cavitary lung lesion in a patient with systemic lupus erythematosus receiving immunosuppressive treatment. The lesion was confirmed by positive polymerase chain reaction (PCR) for CMV in bronchoalveolar lavage fluid (BALF) and CMV antigenemia. PCR for CMV in BALF was demonstrated to be useful for the diagnosis of CMV pneumonitis on the basis of high sensitivity and specificity. After initiating ganciclovir, the lesion gradually regressed. A cavitary lung lesion associated with CMV is extremely rare. This presentation suggests that the differential diagnosis of cavitary lung lesion in immunocompromised individuals should include CMV.

摘要

我们报告一例巨细胞病毒（CMV）肺炎，该病例表现为一名接受免疫抑制治疗的系统性红斑狼疮患者出现肺部空洞性病变。通过支气管肺泡灌洗（BALF）液中CMV聚合酶链反应（PCR）阳性及CMV抗原血症确诊该病变。基于高敏感性和特异性，BALF中CMV的PCR检测被证明对CMV肺炎的诊断有用。开始使用更昔洛韦后，病变逐渐消退。与CMV相关的肺部空洞性病变极为罕见。这一表现提示免疫功能低下个体肺部空洞性病变的鉴别诊断应包括CMV。