An overwhelming pulmonary fungusball in a systemic lupus erythematosus patient
Identifieur interne : 002140 ( Main/Exploration ); précédent : 002139; suivant : 002141An overwhelming pulmonary fungusball in a systemic lupus erythematosus patient
Auteurs : E. Kocakoc [Turquie] ; S. Ozgocmen [Turquie] ; A. Kiris [Turquie] ; L. Ozcakar [Turquie] ; Y. Boztosun [Turquie] ; N. Yildirim [Turquie]Source :
- Zeitschrift für Rheumatologie [ 0340-1855 ] ; 2003-12-01.
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Abstract
Zusammenfassung. : Impaired host immunity has been regarded as a predisposing factor in postprimary tuberculosis in adults. Patients with systemic lupus erythematosus (SLE) are usually exposed to high doses of corticosteroids and eventually develop defective cellular immunity that increases the risk for active tuberculosis. SLE-associated pulmonary tuberculosis tends to have a higher incidence of miliary, far-advanced pulmonary disease and therefore establishing the diagnosis can easily be delayed due to generalized, non-specific clinical symptoms such as fever, malaise and weight loss which are also commonly observed in lupus patients. However, cavitary tuberculosis is very rare in patients with SLE. To the best of our knowledge, fungus ball formation in the tuberculosis cavity in a patient with SLE, has not been previously reported. Thus, we present a case of SLE who was found to have a fungus ball within a preexisting tuberculosis cavity. The diagnosis was resolved by computerized tomography of the chest and was confirmed with histopathological examination.
Summary. : Es wird angenommen, dass Erwachsene mit reduzierter Immunität ein höheres Risiko aufweisen, an einer postprimären Tuberkulose zu erkranken. SLE-Patienten entwickeln Aufgrund der hoch dosierten Corticosteroid-Behandlung einer defekte zelluläre Immunität, welche ein erhöhtes Risiko für aktive Tuberkulose ist. Bei Patienten mit SLE und Lungentuberkulose ist die Diagnose nicht leicht zu stellen, da klinische Symptome, wie z. B. Fieber, allgemeine Schwäche, Gewichtsverlust, auch zum Krankheitsbild des SLE gehören, deswegen wird die Diagnose eine Tuberkulose bei SLE erst spät gestellt, z. B. im Stadium Miliartuberkulose oder fortgeschrittene Lungentuberkulose. Allerdings ist die kavernöse Lungentuberkulose bei SLE Patienten sehr selten. Nach unseren Kentnissen ist die Entstehung eines Aspergilloms bei SLE Patienten mit kavernöse Lungentuberkulose bisher nicht berichtet worden. Hier präsentieren wir einen Fall von SLE, der ein Aspergillom in einer bereits bestehenden Tuberkulosekaverne hatte. Diese Diagnose wurde durch Computertomographie des Thorax gestellt und histopatologisch bestätigt.
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DOI: 10.1007/s00393-003-0492-0
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Kiris</name><affiliation wicri:level="1"><country xml:lang="fr">Turquie</country><wicri:regionArea>Department of Radiology, Firat University, Faculty of Medicine, 23119, Elazig</wicri:regionArea><wicri:noRegion>Elazig</wicri:noRegion></affiliation></author><author><name sortKey="Ozcakar, L" sort="Ozcakar, L" uniqKey="Ozcakar L" first="L." last="Ozcakar">L. Ozcakar</name><affiliation wicri:level="1"><country xml:lang="fr">Turquie</country><wicri:regionArea>Department of Physical Medicine and Rehabilitation, Hacettepe University, School of Medicine, Ankara</wicri:regionArea><wicri:noRegion>Ankara</wicri:noRegion></affiliation></author><author><name sortKey="Boztosun, Y" sort="Boztosun, Y" uniqKey="Boztosun Y" first="Y." last="Boztosun">Y. 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Yildirim</name><affiliation wicri:level="1"><country xml:lang="fr">Turquie</country><wicri:regionArea>Department of Pathology, State Hospital, Elazig</wicri:regionArea><wicri:noRegion>Elazig</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Zeitschrift für Rheumatologie</title><title level="j" type="abbrev">Z Rheumatol</title><idno type="ISSN">0340-1855</idno><idno type="eISSN">1435-1250</idno><imprint><publisher>Steinkopff-Verlag</publisher><pubPlace>Darmstadt</pubPlace><date type="published" when="2003-12-01">2003-12-01</date><biblScope unit="volume">62</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="570">570</biblScope><biblScope unit="page" to="573">573</biblScope></imprint><idno type="ISSN">0340-1855</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0340-1855</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Fungus ball</term><term>computed tomography</term><term>corticosteroid treatment</term><term>systemic lupus erythematosus</term><term>tuberculosis</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Zusammenfassung. : Impaired host immunity has been regarded as a predisposing factor in postprimary tuberculosis in adults. Patients with systemic lupus erythematosus (SLE) are usually exposed to high doses of corticosteroids and eventually develop defective cellular immunity that increases the risk for active tuberculosis. SLE-associated pulmonary tuberculosis tends to have a higher incidence of miliary, far-advanced pulmonary disease and therefore establishing the diagnosis can easily be delayed due to generalized, non-specific clinical symptoms such as fever, malaise and weight loss which are also commonly observed in lupus patients. However, cavitary tuberculosis is very rare in patients with SLE. To the best of our knowledge, fungus ball formation in the tuberculosis cavity in a patient with SLE, has not been previously reported. Thus, we present a case of SLE who was found to have a fungus ball within a preexisting tuberculosis cavity. The diagnosis was resolved by computerized tomography of the chest and was confirmed with histopathological examination.</div><div type="abstract" xml:lang="de">Summary. : Es wird angenommen, dass Erwachsene mit reduzierter Immunität ein höheres Risiko aufweisen, an einer postprimären Tuberkulose zu erkranken. SLE-Patienten entwickeln Aufgrund der hoch dosierten Corticosteroid-Behandlung einer defekte zelluläre Immunität, welche ein erhöhtes Risiko für aktive Tuberkulose ist. Bei Patienten mit SLE und Lungentuberkulose ist die Diagnose nicht leicht zu stellen, da klinische Symptome, wie z. B. Fieber, allgemeine Schwäche, Gewichtsverlust, auch zum Krankheitsbild des SLE gehören, deswegen wird die Diagnose eine Tuberkulose bei SLE erst spät gestellt, z. B. im Stadium Miliartuberkulose oder fortgeschrittene Lungentuberkulose. Allerdings ist die kavernöse Lungentuberkulose bei SLE Patienten sehr selten. Nach unseren Kentnissen ist die Entstehung eines Aspergilloms bei SLE Patienten mit kavernöse Lungentuberkulose bisher nicht berichtet worden. Hier präsentieren wir einen Fall von SLE, der ein Aspergillom in einer bereits bestehenden Tuberkulosekaverne hatte. Diese Diagnose wurde durch Computertomographie des Thorax gestellt und histopatologisch bestätigt.</div></front></TEI><affiliations><list><country><li>Turquie</li></country></list><tree><country name="Turquie"><noRegion><name sortKey="Kocakoc, E" sort="Kocakoc, E" uniqKey="Kocakoc E" first="E." last="Kocakoc">E. Kocakoc</name></noRegion><name sortKey="Boztosun, Y" sort="Boztosun, Y" uniqKey="Boztosun Y" first="Y." last="Boztosun">Y. Boztosun</name><name sortKey="Kiris, A" sort="Kiris, A" uniqKey="Kiris A" first="A." last="Kiris">A. Kiris</name><name sortKey="Ozcakar, L" sort="Ozcakar, L" uniqKey="Ozcakar L" first="L." last="Ozcakar">L. Ozcakar</name><name sortKey="Ozgocmen, S" sort="Ozgocmen, S" uniqKey="Ozgocmen S" first="S." last="Ozgocmen">S. Ozgocmen</name><name sortKey="Yildirim, N" sort="Yildirim, N" uniqKey="Yildirim N" first="N." last="Yildirim">N. Yildirim</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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