title: [A case of Wegener's granulomatosis complicated with cytomegalovirus pneumonia during the treatment with immunosuppressants].
abstract: Wegener's granulomatosis was diagnosed in a 60-year-old man on the basis of an increase in serum C-ANCA and of pathological findings obtained by computed tomography-guided lung biopsy. The treatment with prednisolone and cyclophosphamide reduced his symptoms and laboratory data including serum C-ANCA. However, the treatment decreased the peripheral blood lymphocyte count and the patient subsequently complained of a sudden onset of dyspnea. Although chest radiography appeared normal, antigenemia and the polymerase chain reaction for Cytomegalovirus were positive, and also there was an increase in serum antibody titer for Cytomegalovirus. Intravenous administration of Ganciclovir and cessation of cyclophosphamide successfully improved the patient's symptoms. Antigenemia and the polymerase chain reaction for Cytomegalovirus also became negative following the treatment. Thus, it is important to consider the development of opportunistic infections including Cytomegalovirus pneumonia during the treatment of Wegener's granulomatosis with immunosuppressant.
authors.affiliation: Second Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kondo
authors.forename: Hiroto
authors.initials: H
authors.lastname: Matsuse
authors.forename: Ikuko
authors.initials: I
authors.lastname: Machida
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kawano
authors.forename: Shin-ya
authors.initials: SY
authors.lastname: Tomari
authors.forename: Kazuko
authors.initials: K
authors.lastname: Izaki
authors.forename: Terufumi
authors.initials: T
authors.lastname: Shimoda
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000209:etiology*; D004359:Drug Therapy, Combination; D015774:Ganciclovir / Q000008:administration & dosage; D014890:Granulomatosis with Polyangiitis / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011024:Pneumonia, Viral / Q000188:drug therapy / Q000209:etiology*; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011239:Prednisolone; D015774:Ganciclovir