[A case of ankylosing spondylitis associated with pulmonary aspergillosis and amyloidosis].
A 56-year-old man was admitted because of diarrhea, cough, weight loss, and disturbance of consciousness. He had been diagnosed as having ankylosing spondylitis at 18-years old. The spondylitis progressed until there was complete rigidity of the spine including the neck, hip and knee joints. Human leukocyte antigen (HLA) B27, which has been characteristic of ankylosing spondylitis, was also present in this case. A chest radiograph showed pleural thickness and a cavity in the right upper lobe; and a soft tissue mass and fluid level was found in the cavity. Aspergillus fumigatus was detected in the sputum and pulmonary aspergillosis was diagnosed. Biopsy of the colon revealed that a large interstitial amyloidosis. Despite the treatment of the patient's malnutrition and lung aspergillosis using amphotericin B, the clinical course was rapidly progressive and the patient died of respiratory failure due to lung aspergillosis. It is important to be aware of these rare complications, which are correlated with the prognosis in cases of ankylosing spondylitis.
Tokimatsu
I
I
Third Department of Internal Medicine, Oita Prefectural Hospital, 476 Bunyou, Oita, Oita 870-0855, Japan.
Uenishi
Y
Y
Nakama
K
K
Yamasaki
T
T
Miyazaki
T
T
Nasu
M
M
D000686:Amyloidosis / Q000209:etiology*; D001228:Aspergillosis / Q000209:etiology*; D001232:Aspergillus fumigatus; D006801:Humans; D008172:Lung Diseases, Fungal / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D013167:Spondylitis, Ankylosing / Q000150:complications*