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.
First Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan. kogen@me.ndmc.ac.jp
Kunio
K
Takada
Kimihiro
K
Suzuki
Koji
K
Kataharada
Makoto
M
Okada
Masahiro
M
Nakashima
Takashi
T
Nakanishi
Fumitaka
F
Ohsuzu
Takashi
T
Yoshiyama
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