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Disseminated toxoplasmosis with atypical symptoms which developed with exacerbation of systemic lupus erythematosus.
Lupus 2019; 28(1):133-136L

Abstract

Toxoplasma is a common parasite worldwide that mainly affects the brain, lungs and eyes. Although toxoplasmic encephalitis is a lethal disease without treatment, past case reports show most patients with systemic lupus erythematosus who developed toxoplasmic encephalitis were misdiagnosed and treated as neuropsychiatric systemic lupus erythematosus, which led to unfavorable outcomes. We herein describe a case of disseminated toxoplasmosis affecting all the above organs with atypical symptoms, which developed with exacerbation of systemic lupus erythematosus. She had initially manifested with retinochoroiditis without vitritis, mild cognitive impairment and an isolated lung mass. These are completely different from the classic symptoms of toxoplasmosis that have been reported in patients with HIV infection and/or those after hematopoietic transplantation. Our case, together with previously reported cases, suggests the manifestation of toxoplasmosis that develops in systemic lupus erythematosus patients can be different from that seen in conventional cases and varies between individual patients. Our case highlights both the difficulty in and the importance of diagnosing toxoplasmosis in patients with systemic lupus erythematosus and provides helpful information to identify this rare, devastating, yet treatable disease.

Authors+Show Affiliations

1 Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan.1 Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan.1 Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan.1 Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan.1 Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan.1 Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan.1 Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan.2 Department of Ophthalmology and Visual Science, Chiba University, Graduate School of Medicine, Japan.3 Department of Allergy and Rheumatology, Japanese Red Cross Narita Hospital, Chiba, Japan.4 Department of Infectious Diseases, Japanese Red Cross Narita Hospital, Chiba, Japan.5 Department of Infection and Host Defense, Chiba University, Chiba, Japan.5 Department of Infection and Host Defense, Chiba University, Chiba, Japan.1 Department of Allergy and Clinical Immunology, Chiba University Hospital, Chiba, Japan.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

30486727

Citation

Furuya, H, et al. "Disseminated Toxoplasmosis With Atypical Symptoms Which Developed With Exacerbation of Systemic Lupus Erythematosus." Lupus, vol. 28, no. 1, 2019, pp. 133-136.
Furuya H, Ikeda K, Iida K, et al. Disseminated toxoplasmosis with atypical symptoms which developed with exacerbation of systemic lupus erythematosus. Lupus. 2019;28(1):133-136.
Furuya, H., Ikeda, K., Iida, K., Suzuki, K., Furuta, S., Tamachi, T., ... Nakajima, H. (2019). Disseminated toxoplasmosis with atypical symptoms which developed with exacerbation of systemic lupus erythematosus. Lupus, 28(1), pp. 133-136. doi:10.1177/0961203318815583.
Furuya H, et al. Disseminated Toxoplasmosis With Atypical Symptoms Which Developed With Exacerbation of Systemic Lupus Erythematosus. Lupus. 2019;28(1):133-136. PubMed PMID: 30486727.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Disseminated toxoplasmosis with atypical symptoms which developed with exacerbation of systemic lupus erythematosus. AU - Furuya,H, AU - Ikeda,K, AU - Iida,K, AU - Suzuki,K, AU - Furuta,S, AU - Tamachi,T, AU - Suzuki,K, AU - Miura,G, AU - Hiraguri,M, AU - Hase,R, AU - Hikosaka,K, AU - Norose,K, AU - Nakajima,H, Y1 - 2018/11/28/ PY - 2018/11/30/pubmed PY - 2019/1/15/medline PY - 2018/11/30/entrez KW - Systemic lupus erythematosus KW - cerebral toxoplasmosis KW - disseminated toxoplasmosis KW - neuropsychiatric systemic lupus erythematosus KW - ocular toxoplasmosis KW - pulmonary toxoplasmosis SP - 133 EP - 136 JF - Lupus JO - Lupus VL - 28 IS - 1 N2 - Toxoplasma is a common parasite worldwide that mainly affects the brain, lungs and eyes. Although toxoplasmic encephalitis is a lethal disease without treatment, past case reports show most patients with systemic lupus erythematosus who developed toxoplasmic encephalitis were misdiagnosed and treated as neuropsychiatric systemic lupus erythematosus, which led to unfavorable outcomes. We herein describe a case of disseminated toxoplasmosis affecting all the above organs with atypical symptoms, which developed with exacerbation of systemic lupus erythematosus. She had initially manifested with retinochoroiditis without vitritis, mild cognitive impairment and an isolated lung mass. These are completely different from the classic symptoms of toxoplasmosis that have been reported in patients with HIV infection and/or those after hematopoietic transplantation. Our case, together with previously reported cases, suggests the manifestation of toxoplasmosis that develops in systemic lupus erythematosus patients can be different from that seen in conventional cases and varies between individual patients. Our case highlights both the difficulty in and the importance of diagnosing toxoplasmosis in patients with systemic lupus erythematosus and provides helpful information to identify this rare, devastating, yet treatable disease. SN - 1477-0962 UR - https://www.unboundmedicine.com/medline/citation/30486727/Disseminated_toxoplasmosis_with_atypical_symptoms_which_developed_with_exacerbation_of_systemic_lupus_erythematosus_ L2 - http://journals.sagepub.com/doi/full/10.1177/0961203318815583?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -