一名系统性红斑狼疮患者的巨细胞病毒诱导的间质性肺炎。

Cytomegalovirus-induced interstitial pneumonitis in a patient with systemic lupus erythematosus.

作者信息

Tokunaga Y, Takenaka K, Asayama R, Shibuya T

机构信息

Department of Internal Medicine, Hamanomachi General Hospital, Fukuoka.

出版信息

Intern Med. 1996 Jun;35(6):517-20. doi: 10.2169/internalmedicine.35.517.

DOI:10.2169/internalmedicine.35.517

PMID:8835609

Abstract

We report an unusual case of cytomegalovirus (CMV) interstitial pneumonitis (IP) occurring in a 51-year-old Japanese woman with systemic lupus erythematosus (SLE). She developed hypoxemia after intensive immunosuppressive therapy with prednisolone and cyclophosphamide. Fine crackles were audible in the lower lungs bilaterally. Chest X-ray and computed tomography confirmed the presence of IP. CMV-antigenemia was confirmed by immunological staining of leukocytes using the peroxidase-labeled monoclonal antibody, HRP-C7. Hypoxemia improved gradually on methylprednisolone pulse therapy and gancyclovir, and CMV-antigen positive leukocytes disappeared from the peripheral blood. Data suggest the importance of CMV as a cause of IP in SLE, and the usefulness of the assay for CMV-antigenemia with C7-HRP for rapid diagnosis.

摘要

我们报告了一例罕见的巨细胞病毒（CMV）间质性肺炎（IP）病例，患者为一名51岁的日本女性，患有系统性红斑狼疮（SLE）。她在接受泼尼松龙和环磷酰胺强化免疫抑制治疗后出现低氧血症。双侧下肺可闻及细湿啰音。胸部X线和计算机断层扫描证实存在IP。通过使用过氧化物酶标记的单克隆抗体HRP-C7对白细胞进行免疫染色，确认了CMV抗原血症。在接受甲泼尼龙冲击治疗和更昔洛韦后，低氧血症逐渐改善，外周血中CMV抗原阳性白细胞消失。数据表明CMV作为SLE中IP病因的重要性，以及使用C7-HRP检测CMV抗原血症用于快速诊断的有效性。