免疫再構築症候群に対してステロイド治療が有効であった 高度気道狭窄合併カポジ肉腫症例

DOI Web Site Web Site 参考文献7件
  • 石川 哲也
    群馬大学大学院医学系研究科生体統御内科学 国立病院機構渋川医療センター血液内科
  • 柳澤 邦雄
    群馬大学大学院医学系研究科生体統御内科学
  • 小川 孔幸
    群馬大学大学院医学系研究科生体統御内科学
  • 内海 英貴
    群馬大学大学院医学系研究科生体統御内科学
  • 合田 史
    国立病院機構高崎総合医療センター総合診療科
  • 半田 寛
    群馬大学大学院医学系研究科生体統御内科学

書誌事項

タイトル別名
  • Successful Treatment of Immune Reconstitution Inflammatory Syndrome with Corticosteroid for Patient with Kaposiʼs Sarcoma Extending into the Respiratory Tract and Both Lungs
  • 症例 免疫再構築症候群に対してステロイド治療が有効であった高度気道狭窄合併カポジ肉腫症例
  • ショウレイ メンエキ サイコウチク ショウコウグン ニ タイシテ ステロイド チリョウ ガ ユウコウ デ アッタ コウド キドウ キョウサク ガッペイ カポジ ニクシュ ショウレイ

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<p>An HIV-infected man in his 30s was transferred to our hospital after the discontinuation of antiretroviral therapy (ART) for 4 years. An intraoral tumor was identified, and a biopsy was performed. The diagnosis was Kaposiʼs sarcoma (KS) and disseminated lesions were detected in his respiratory tract and both lungs on computed tomography (CT) and 2-[18F] fluoro-2-deoxy-D-glucose positron-emission tomography (FDG/PET) imaging with increasing standardized uptake volume (SUV：max 7.4). On the 7th day, he was intubated to maintain his airway, then antiretroviral therapy and chemotherapy with pegylated liposomal doxorubicin were immediately initiated. After a period of remission, pulmonary lesions were detected again. We regarded them as a manifestation of immune reconstitution inflammatory syndrome (IRIS) and gave him short term corticosteroids. The lesions were then successfully controlled without additional chemotherapy. This case suggests that early induction of ART and intensive care can result in the survival of patients with KS having serious stenosis of the respiratory tract. Furthermore, this presenting case suggested that the use of corticosteroids could be a candidate to control IRIS even in patients with Kaposiʼs sarcoma.</p>

収録刊行物

  • 感染症学雑誌

    感染症学雑誌 91 (1), 25-30, 2017-01-20

    一般社団法人 日本感染症学会

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