Immune Reconstitution Inflammatory Syndrome Associated with <i>Pneumocystis jirovecii</i> Pneumonia and Cytomegalovirus Colitis in a Patient with Rheumatoid Arthritis
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- Shima Natsuki
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Japan
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- Kokuzawa Ayako
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Japan
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- Saito Keisuke
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Japan
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- Kamata Yasuyuki
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Japan
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- Nagashima Takao
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Japan
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- Sato Kojiro
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Jichi Medical University, Japan
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抄録
<p>A 68-year-old woman presenting with rheumatoid arthritis was admitted due to pancytopenia caused by methotrexate. Pneumocystis jirovecii pneumonia was diagnosed based on the abnormal shadows observed on chest computed tomography, the presence of serum β-D-glucan, and positive P. jirovecii-DNA results in a sputum analysis. Subsequently, after treatment with leucovorin and trimethoprim-sulfamethoxazole, lung consolidation was found to be aggravated, along with a rapidly increasing leukocyte count. In addition, cytomegalovirus colitis was diagnosed. Both conditions were associated with immune reconstitution inflammatory syndrome caused by recovery from leukopenia. The patient was successfully treated with intravenous methylprednisolone pulse therapy and ganciclovir. </p>
収録刊行物
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- Internal Medicine
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Internal Medicine 61 (2), 245-248, 2022-01-15
一般社団法人 日本内科学会
