A patient with a Mycobacterium avium complex infection complicated by systemic lupus erythematosus.
A 41-year-old woman was admitted to our hospital because of fever and polyarthralgia. A diagnosis of systemic lupus erythematosus (SLE) was made based on the findings of polyarthritis, leukocytopenia, lymphocytopenia, proteinuria, and positive reactions for antinuclear antibody (ANA) and anti-double strand (ds)DNA antibody. She had also been suffering from a pulmonary Mycobacterium avium complex (MAC) infection with such symptoms as cough and sputum for the past 3 years. Antimicrobial drugs for MAC infection were administered first, and later she was given cyclophosphamide pulse therapy, consisting of methylprednisolone (8 mg/day) and mizoribine (100 mg/day). Owing to these therapeutic regimens, SLE was successfully treated without an exacerbation of the MAC infection. The risk factors for MAC infection and SLE are also discussed.
Takada
Kunio
K
First Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan. kogen@me.ndmc.ac.jp
Suzuki
Kimihiro
K
Kataharada
Koji
K
Okada
Makoto
M
Nakashima
Masahiro
M
Nakanishi
Takashi
T
Ohsuzu
Fumitaka
F
Yoshiyama
Takashi
T
D000328:Adult; D000995:Antitubercular Agents / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D015269:Mycobacterium avium Complex / Q000302:isolation & purification; D015270:Mycobacterium avium-intracellulare Infection / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D020551:Pulse Therapy, Drug; D014057:Tomography, X-Ray Computed
D000995:Antitubercular Agents; D003520:Cyclophosphamide