title: Cryptococcal meningitis in patients with autoimmune hemolytic anemia.
abstract: To summarize the epidemiology, clinical features, treatment, and outcome of cryptococcal meningitis (CM) in autoimmune hemolytic anemia (AIHA) patients and to provide a reference for the prevention and control of AIHA complicated with CM, we evaluated five cases of CM in patients with AIHA treated in our hospital from 2003 to 2013 and eight related foreign cases. All of the clinical isolates were Cryptococcus neoformans var. grubii and grouped into the VNI genotype and serotype A. The clinical features exhibit significant features. Headache, nausea, and fever are common symptoms of AIHA complicated with CM. The early clinical manifestations lack specificity, which may lead to delayed diagnosis and treatment. Long-term use of prednisone (≥15 mg day(-1)), poor control of anemia, and splenectomy are risk factors for AIHA complicated with cryptococcal infection. The combination of intravenous amphotericin B and oral 5-fluorocytosine remains the preferred treatment for AIHA complicated with CM.
authors: Department of Dermatology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, China.
authors: YaLi
authors: Y
authors: Yang
authors: Junjun
authors: J
authors: Sang
authors: Weihua
authors: W
authors: Pan
authors: Lin
authors: L
authors: Du
authors: Wanqing
authors: W
authors: Liao
authors: Jianghan
authors: J
authors: Chen
authors: Yuanjie
authors: Y
authors: Zhu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications*; D000935:Antifungal Agents / Q000627:therapeutic use; D003455:Cryptococcus neoformans / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D005260:Female; D005437:Flucytosine / Q000627:therapeutic use; D005838:Genotype; D006801:Humans; D008297:Male; D016919:Meningitis, Cryptococcal / Q000188:drug therapy / Q000453:epidemiology* / Q000473:pathology*; D008875:Middle Aged; D065288:Serogroup; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B; D005437:Flucytosine