Abstract
We report an unusual case of cytomegalovirus (CMV) interstitial pneumonitis (IP) occurring in a 51-year-old Japanese woman with systemic lupus erythematosus (SLE). She developed hypoxemia after intensive immunosuppressive therapy with prednisolone and cyclophosphamide. Fine crackles were audible in the lower lungs bilaterally. Chest X-ray and computed tomography confirmed the presence of IP. CMV-antigenemia was confirmed by immunological staining of leukocytes using the peroxidase-labeled monoclonal antibody, HRP-C7. Hypoxemia improved gradually on methylprednisolone pulse therapy and gancyclovir, and CMV-antigen positive leukocytes disappeared from the peripheral blood. Data suggest the importance of CMV as a cause of IP in SLE, and the usefulness of the assay for CMV-antigenemia with C7-HRP for rapid diagnosis.
MeSH terms
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Antigens, Viral / blood
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Antiviral Agents / therapeutic use
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Cyclophosphamide / therapeutic use
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Cytomegalovirus / immunology
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Cytomegalovirus / isolation & purification
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Cytomegalovirus Infections / complications*
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Cytomegalovirus Infections / diagnosis
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Cytomegalovirus Infections / drug therapy
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Female
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Ganciclovir / therapeutic use
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Humans
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Hypoxia / etiology
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Immunosuppressive Agents / therapeutic use
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Leukocytes / virology
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Lung Diseases, Interstitial / etiology*
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Lupus Erythematosus, Systemic / complications*
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Methylprednisolone / therapeutic use
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Middle Aged
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Pneumonia, Viral / complications*
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Pneumonia, Viral / diagnosis
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Pneumonia, Viral / drug therapy
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Prednisolone / therapeutic use
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Viremia / complications
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Viremia / diagnosis
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Viremia / virology
Substances
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Antigens, Viral
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Antiviral Agents
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Immunosuppressive Agents
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Cyclophosphamide
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Prednisolone
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Ganciclovir
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Methylprednisolone