title: Pneumocystis Pneumonia Concomitant with Ectopic ACTH Syndrome Caused by a Large Cell Neuroendocrine Carcinoma of the Thymus.
abstract: We herein report the case of a 44-year-old man who was diagnosed with pneumocystis pneumonia (PCP) concomitant with ectopic adrenocorticotropic hormone (ACTH) syndrome, which had been caused by a large cell neuroendocrine carcinoma of the thymus. Chest computed tomography revealed ground-glass opacities in the lungs. PCP was diagnosed by a polymerase chain reaction with bronchoalveolar lavage. The levels of cortisol were slowly corrected with an adrenal enzyme inhibitor, and the exacerbation of PCP was successfully avoided. Our case indicates that in addition to prophylaxis, the early diagnosis of PCP and the slow correction of hypercortisolemia should be considered in order to prevent an exacerbation due to the reconstitution of the immune function in patients with ectopic ACTH syndrome.
authors.affiliation: Department of Allergy and Respiratory Medicine, Okayama University Hospital, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Oda
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Miyahara
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tabata
authors.forename: Daisuke
authors.initials: D
authors.lastname: Minami
authors.forename: Kiichiro
authors.initials: K
authors.lastname: Ninomiya
authors.forename: Arihiko
authors.initials: A
authors.lastname: Kanehiro
authors.forename: Motoshi
authors.initials: M
authors.lastname: Komatsubara
authors.forename: Kenichi
authors.initials: K
authors.lastname: Inagaki
authors.forename: Mitsune
authors.initials: M
authors.lastname: Tanimoto
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Kiura
mesh_terms: D000182:ACTH Syndrome, Ectopic / Q000150:complications* / Q000188:drug therapy; D000328:Adult; D018893:Bronchoalveolar Lavage; D018278:Carcinoma, Neuroendocrine / Q000150:complications*; D042241:Early Diagnosis; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008797:Metyrapone / Q000627:therapeutic use; D009894:Opportunistic Infections / Q000150:complications* / Q000175:diagnosis; D011020:Pneumonia, Pneumocystis / Q000150:complications* / Q000175:diagnosis; D013953:Thymus Neoplasms / Q000150:complications*; D014057:Tomography, X-Ray Computed
chemical_list: D004791:Enzyme Inhibitors; D006854:Hydrocortisone; D008797:Metyrapone