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[A case report--pulmonary cryptococcosis associated with systemic lupus erythematosus and review of 44 cases in Japan].
Ryumachi 1993; 33(1):56-62R

Abstract

A case of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) associated with pulmonary cryptococcosis which was successfully treated with fluconazole (FCZ) and flucytosine (5-FC) is described. A 63-year-old woman who had been treated with steroid for SLE and low dose methotrexate (MTX) for RA was admitted to Jichi Medical School Hospital because of abnormal shadow in the chest X-ray film. Physical examination revealed no abnormality. A chest CT film showed multiple nodular shadows localized in the right lower lobe. An ultrasonically guided trans-cutaneous lung biopsy performed on 10th hospital day established a diagnosis of pulmonary cryptococcosis. Following the treatment with FCZ and 5-FC for a month, her abnormal lung shadows improved and serum cryptococcal antigen level was decreased. A survey of the literature from 1955 to 1990 revealed 44 cases of SLE associated with cryptococcosis in Japan, in addition to our case, most of whom were on corticosteroid therapy. The majority of patients were young women, representing the usual population of patients with SLE. 34 of these patients had cryptococcal meningitis; 22, pulmonary cryptococcosis; 6, sepsis; 6 cutaneous cryptococcosis. Twenty patients died. Deep fungal infections should be considered whenever patients with SLE have fever of unknown origin, diffuse pulmonary infiltrates, or unexplained CNS symptoms.

Authors+Show Affiliations

Department of Clinical Immunology, Jichi Medical School, Tochigi.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
English Abstract
Journal Article
Review

Language

jpn

PubMed ID

8493585

Citation

Sato, M, et al. "[A Case Report--pulmonary Cryptococcosis Associated With Systemic Lupus Erythematosus and Review of 44 Cases in Japan]." Ryumachi. [Rheumatism], vol. 33, no. 1, 1993, pp. 56-62.
Sato M, Saku N, Takeda A, et al. [A case report--pulmonary cryptococcosis associated with systemic lupus erythematosus and review of 44 cases in Japan]. Ryumachi. 1993;33(1):56-62.
Sato, M., Saku, N., Takeda, A., Suzuki, N., Saito, T., Minato, N., ... Kano, S. (1993). [A case report--pulmonary cryptococcosis associated with systemic lupus erythematosus and review of 44 cases in Japan]. Ryumachi. [Rheumatism], 33(1), pp. 56-62.
Sato M, et al. [A Case Report--pulmonary Cryptococcosis Associated With Systemic Lupus Erythematosus and Review of 44 Cases in Japan]. Ryumachi. 1993;33(1):56-62. PubMed PMID: 8493585.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [A case report--pulmonary cryptococcosis associated with systemic lupus erythematosus and review of 44 cases in Japan]. AU - Sato,M, AU - Saku,N, AU - Takeda,A, AU - Suzuki,N, AU - Saito,T, AU - Minato,N, AU - Saito,K, AU - Kano,S, PY - 1993/2/1/pubmed PY - 1993/2/1/medline PY - 1993/2/1/entrez SP - 56 EP - 62 JF - Ryumachi. [Rheumatism] JO - Ryumachi VL - 33 IS - 1 N2 - A case of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) associated with pulmonary cryptococcosis which was successfully treated with fluconazole (FCZ) and flucytosine (5-FC) is described. A 63-year-old woman who had been treated with steroid for SLE and low dose methotrexate (MTX) for RA was admitted to Jichi Medical School Hospital because of abnormal shadow in the chest X-ray film. Physical examination revealed no abnormality. A chest CT film showed multiple nodular shadows localized in the right lower lobe. An ultrasonically guided trans-cutaneous lung biopsy performed on 10th hospital day established a diagnosis of pulmonary cryptococcosis. Following the treatment with FCZ and 5-FC for a month, her abnormal lung shadows improved and serum cryptococcal antigen level was decreased. A survey of the literature from 1955 to 1990 revealed 44 cases of SLE associated with cryptococcosis in Japan, in addition to our case, most of whom were on corticosteroid therapy. The majority of patients were young women, representing the usual population of patients with SLE. 34 of these patients had cryptococcal meningitis; 22, pulmonary cryptococcosis; 6, sepsis; 6 cutaneous cryptococcosis. Twenty patients died. Deep fungal infections should be considered whenever patients with SLE have fever of unknown origin, diffuse pulmonary infiltrates, or unexplained CNS symptoms. SN - 0300-9157 UR - https://www.unboundmedicine.com/medline/citation/8493585/[A_case_report__pulmonary_cryptococcosis_associated_with_systemic_lupus_erythematosus_and_review_of_44_cases_in_Japan]_ L2 - http://www.diseaseinfosearch.org/result/9373 DB - PRIME DP - Unbound Medicine ER -