Ikuma Daisuke, Yokota Kazuhiro, Sato Kojiro, Mimura Toshihide
Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University.
Nihon Rinsho Meneki Gakkai Kaishi. 2017;40(1):78-82. doi: 10.2177/jsci.40.78.
When patients with autoimmune diseases, such as rheumatoid arthritis (RA), are treated with potent immunosuppressive therapy, the risk of opportunistic diseases inevitably increases. If patients have the misfortune to suffer from both opportunistic and active autoimmune diseases, correct diagnosis could sometimes be difficult since both diseases have inflammatory nature. The choice of treatment is another challenge in that aggressive immunosuppressive therapy can fuel the opportunistic infection. Here we report a case of RA patient with new onset rheumatoid vasculitis that was diagnosed in the process of treatment of Pneumocystis jirovecii pneumonia.
当自身免疫性疾病患者,如类风湿关节炎(RA),接受强效免疫抑制治疗时,机会性疾病的风险不可避免地会增加。如果患者不幸同时患有机会性疾病和活动性自身免疫性疾病,由于这两种疾病都具有炎症性质,有时可能难以做出正确诊断。治疗的选择是另一个挑战,因为积极的免疫抑制治疗可能会加剧机会性感染。在此,我们报告一例类风湿关节炎患者,在治疗耶氏肺孢子菌肺炎过程中被诊断出患有新发类风湿性血管炎。