Cytomegalovirus-induced interstitial pneumonitis in a patient with systemic lupus erythematosus.
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.
Tokunaga
Y
Y
Department of Internal Medicine, Hamanomachi General Hospital, Fukuoka.
Takenaka
K
K
Asayama
R
R
Shibuya
T
T
D000956:Antigens, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000276:immunology / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007962:Leukocytes / Q000821:virology; D017563:Lung Diseases, Interstitial / Q000209:etiology*; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011024:Pneumonia, Viral / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use; D014766:Viremia / Q000150:complications / Q000175:diagnosis / Q000821:virology
D000956:Antigens, Viral; D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011239:Prednisolone; D015774:Ganciclovir; D008775:Methylprednisolone