臨床症状が軽度であったカリニ肺炎を合併した,ANCA関連腎炎による血液透析患者の一例

概要

論文の詳細を見る
A 75-year-old woman on hemodialysis was admitted to our hospital with dyspnea and low grade fever on June 2007. She had been diagnosed as having ANCA-associated glomerulonephritis and interstitial pneumonia in March 2002 and been on treatment with steroids and immunosuppressants. She was diagnosed to have pneumocystis carinii pneumonia based on elevation of the serum levels of LDH and 1→3-β-D-glucan, and sputum culture, although the symptoms and chest X-ray findings were not typical. Treatment with sulfamethoxazole-trimethoprim resulted in immediate improvement of her symptoms and laboratory data. Infections, including Pneumocystis carinii pneumonia, have been considered to be one of the most important prognostic factors in patients with ANCA-associated vasculitis on hemodialysis. Therefore, we emphasize the importance of prompt and accurate diagnosis and treatment in these cases. In addition, precautions should be continuously taken against opportunistic infections such as Pneumocystis carinii pneumonia.
東京女子医科大学の論文