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Steroid Tedavisi Alan HIV Seronegatif Sistemik Lupus Eritematozisli Bir Hastada Atipik Grnml Pnmosistis Pnmonisi [Respir Case Rep]
Respir Case Rep. 2018; 7(2): 82-85 | DOI: 10.5505/respircase.2018.49379

Steroid Tedavisi Alan HIV Seronegatif Sistemik Lupus Eritematozisli Bir Hastada Atipik Grnml Pnmosistis Pnmonisi

Gina Amanda1, Dianiati Kusumo Sutoyo1

Pnmosistis pnmonisi (PP) HIV'li hastalarda sk grlrken sistemik lupus eritematozisli (SLE) gibi otoimmn hastal olanlarda nadirdir. Yksek doz steriod kullanm, ar hastalk, bbrek tutulumu, lenfosit ve CD4+saysnda dklk gibi baz nedenler SLE hastalarnda PP iin risk oluturabilmektedir. Burada, yksek doz steroid tedavi alan SLE'li 23 yandaki kadn olgu sunulmutur. Steroid dozu azaltld srada kuru ksrk ve devam eden ate yaknmalar ile klinie yatrld. Yksek znrlkl toraks tomografisinde, intraseptal kalnlamalar, subplevral nodller ve 4L, 6 ve 7 nolu lenf nodlarnda byme saptand. ndkte balgam rneinin PCR ile yaplan incelemesinde Pneumocystis jirovecii pozitif bulundu. Trimetoprim/Slfametaksazol tedavisi 14 gn uyguland ve klinik iyileme gzlendi.

Anahtar Kelimeler: CD lenfosit, pnmositis pnmonisi, sistemik lupus eritematozis

Pneumocystis Pneumonia with Atypical Presentation in an HIV Seronegative Patient with Systemic Lupus Erythematosus during Steroid Therapy

Gina Amanda, Dianiati Kusumo Sutoyo
Department of Pulmonology and Respiratory Medicine Faculty of Medicine Universitas Indonesia, Persahabatan Hospital, Jakarta, Indonesia

Pneumocystis pneumonia (PCP) is common among HIV patients, but it is rare in patients with autoimmune diseases such as systemic lupus erythematosus (SLE). Some of the risk factors related to PCP in SLE patients include a high steroid dose, greater disease activity, renal involvement, and lower lymphocyte and CD4+ counts. Described herein is the case of a 23-year-old female with SLE who was treated with high-dose steroid therapy. She was admitted to the clinic with a dry cough and a prolonged fever persisting since the tapering of the steroid dose. High-resolution computed tomography of the thorax revealed intraseptal thickening, subpleural nodules, and enlargement of the 4L, 6, and 7 lymph nodes. A laboratory examination of an induced sputum sample using polymerase chain reaction was positive for Pneumocystis jirovecii. Trimethoprim/sulfamethoxazole was administered for 14 days and clinical improvement was observed.

Keywords: CD4 lymphocyte, pneumocystis pneumonia, systemic lupus erythematosus.

Gina Amanda, Dianiati Kusumo Sutoyo. Pneumocystis Pneumonia with Atypical Presentation in an HIV Seronegative Patient with Systemic Lupus Erythematosus during Steroid Therapy. Respir Case Rep. 2018; 7(2): 82-85

Sorumlu Yazar: Gina Amanda, Indonesia
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