一名类风湿关节炎患者因水痘-带状疱疹病毒再感染和EB病毒激活引发肺炎和脑膜脑炎
Pneumonia and Meningoencephalitis Due to Varicella-zoster Virus Reinfection and Epstein-Barr Virus Reactivation in a Patient with Rheumatoid Arthritis.
作者信息
Ito Noriaki, Masuda Takeshi, Yamaguchi Kakuhiro, Sakamoto Shinjiro, Horimasu Yasushi, Nakashima Taku, Miyamoto Shintaro, Iwamoto Hiroshi, Fujitaka Kazunori, Hamada Hironobu, Chayama Kazuaki, Hattori Noboru
机构信息
Department of Internal Medicine, Hiroshima City Funairi Citizens Hospital, Japan.
Department of Respiratory Internal Medicine, Hiroshima University Hospital, Japan.
出版信息
Intern Med. 2022 Oct 1;61(19):2961-2965. doi: 10.2169/internalmedicine.8413-21. Epub 2022 Mar 5.
A 72-year-old woman with rheumatoid arthritis was treated with methotrexate (MTX) and iguratimod. Upon examination of a liver tumor, blisters due to varicella-zoster virus (VZV) infection were observed. Despite oral administration of valacyclovir, she developed varicella pneumonia and meningoencephalitis. A VZV antibody test revealed reinfection. The liver tumor shrank after discontinuance of MTX, and polymerase chain reaction revealed the reactivation of the Epstein-Barr virus (EBV). Therefore, we were unable to deny MTX-associated lymphoproliferative disorder (MTX-LPD). This is the first case of a complication of pneumonia and meningoencephalitis due to VZV reinfection and EBV reactivation.
一名72岁患类风湿关节炎的女性接受了甲氨蝶呤（MTX）和艾拉莫德治疗。在检查肝脏肿瘤时，观察到由水痘-带状疱疹病毒（VZV）感染引起的水疱。尽管口服了伐昔洛韦，她仍患上了水痘肺炎和脑膜脑炎。VZV抗体检测显示为再次感染。停用MTX后肝脏肿瘤缩小，聚合酶链反应显示爱泼斯坦-巴尔病毒（EBV）重新激活。因此，我们无法排除MTX相关淋巴增殖性疾病（MTX-LPD）。这是首例因VZV再次感染和EBV重新激活导致肺炎和脑膜脑炎并发症的病例。
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