[A case of SLE presenting the features of antiphospholipid antibody syndrome during a treatment for complicated cryptococcal meningitis].
A 39-year-old woman had developed systemic lupus erythematosus(SLE) at the age of 29. She had a long history of immunosuppressant therapies such as corticosteroid. On admission, she presented a headache due to the cryptococcal meningitis which was confirmed by lumbar puncture. Combined medications of amphotericin B and fluconazole were not effective, and combined amphotericin B and flucytosine were replaced. Prednisolone and methotrexate had been tapered gradually. Fifty days after the initial treatment for meningitis Cryptococcal neoformans was not observed in the cerebrospinal fluid. Sixty days after the treatment, thrombocytopenia was observed with positive lupus anticoagulant and anticardiolipin antibody. Following which, thrombophlebitis occurred in the left brachium. We suggest that the provoked pathoimmunological reaction such as antiphospholipid antibody syndrome during the treatment for meningitis needs to be cared during the course of SLE.
Izumi
Y
Y
Department of Neurology, Sumitomo Hospital, Japan.
Sakoda
H
H
Udaka
F
F
Kameyama
M
M
D000328:Adult; D000666:Amphotericin B / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D016736:Antiphospholipid Syndrome / Q000209:etiology*; D005260:Female; D005437:Flucytosine / Q000008:administration & dosage; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D016919:Meningitis, Cryptococcal / Q000188:drug therapy* / Q000209:etiology; D008727:Methotrexate / Q000008:administration & dosage; D011239:Prednisolone / Q000008:administration & dosage; D013921:Thrombocytopenia / Q000209:etiology; D013924:Thrombophlebitis / Q000209:etiology
D000935:Antifungal Agents; D007166:Immunosuppressive Agents; D000666:Amphotericin B; D011239:Prednisolone; D005437:Flucytosine; D008727:Methotrexate