Ogai Asuka, Yagi Kazuma, Ito Fumimaro, Domoto Hideharu, Shiomi Tetsuya, Chin Kenko
Department of Hematology, Department of Medicine, Keiyu Hospital, Japan.
Department of Pulmonary Medicine, Department of Medicine, Keiyu Hospital, Japan.
Intern Med. 2022 Apr 15;61(8):1271-1278. doi: 10.2169/internalmedicine.6436-20. Epub 2021 Sep 25.
Ruxolitinib, a Janus kinase inhibitor, improves symptoms in patients with myelofibrosis. However, its association with the development of opportunistic infections has been a concern. We herein report a 71-year-old man with primary myelofibrosis who developed disseminated tuberculosis and concurrent disseminated cryptococcosis during ruxolitinib treatment. We also reviewed the literature on disseminated tuberculosis and/or cryptococcosis associated with ruxolitinib treatment. This is the first case of disseminated tuberculosis and concurrent disseminated cryptococcosis during treatment with ruxolitinib. We therefore suggest considering not only disseminated tuberculosis but also cryptococcosis in the differential diagnosis of patients with abnormal pulmonary shadows during ruxolitinib treatment.
芦可替尼是一种Janus激酶抑制剂,可改善骨髓纤维化患者的症状。然而,其与机会性感染的发生之间的关联一直令人担忧。我们在此报告一名71岁的原发性骨髓纤维化男性患者,在接受芦可替尼治疗期间发生了播散性结核病并并发播散性隐球菌病。我们还回顾了与芦可替尼治疗相关的播散性结核病和/或隐球菌病的文献。这是首例在芦可替尼治疗期间发生播散性结核病并并发播散性隐球菌病的病例。因此,我们建议在对芦可替尼治疗期间肺部阴影异常的患者进行鉴别诊断时,不仅要考虑播散性结核病,还要考虑隐球菌病。