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Disseminated histoplasmosis in systemic lupus erythematosus: case report and review of the literature.

Abstract：

OBJECTIVES:To report a patient who developed both central nervous system systemic lupus erythematosus (SLE) and disseminated histoplasmosis and to review the literature regarding histoplasma infection in patients with SLE. METHODS:MEDLINE review of the medical literature published in English. RESULTS:Disseminated histoplasmosis occurs rarely in patients with SLE. The main risk factor is treatment with corticosteroids at doses of 20 mg/d or greater. Fever, dyspnea, pleurisy, and weight loss are typical presenting symptoms. The most commonly involved tissues are lung, liver, and bone marrow. In our patient, both SLE flare and disseminated histoplasmosis were present simultaneously. CONCLUSIONS:Opportunistic infection is an important complication of SLE and may be difficult to diagnose. Symptoms of infection may mimic those of a lupus flare, or conversely, symptoms may be masked by the use of corticosteroids. Fever, unexplained tissue involvement, atypical clinical patterns, and poor response to immunosuppressive therapy should alert the clinician to aggressively pursue evaluation of possible infection in patients with SLE.

journal_name

Semin Arthritis Rheum

journal_title

Seminars in arthritis and rheumatism

authors

Hansen KE,St Clair EW

doi

10.1016/s0049-0172(98)80036-x

subject

Has Abstract

pub_date

1998-12-01 00:00:00

pages

193-9

issue

3

eissn

0049-0172

issn

1532-866X

pii

S0049-0172(98)80036-X

journal_volume

28

pub_type

杂志文章,评审

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