ステロイド性精神病のため免疫抑制療法が中断されたウェゲナー肉芽腫症の臨床経過について

DOI

書誌事項

タイトル別名
  • Clinical course of a case of Wegener’s granulomatosis where immunosuppression was interrupted by steroid-induced psychosis

この論文をさがす

抄録

    A 54-year-old Japanese female suffered from high fever and persistent cough on February 2006. The patient went to previous doctor and a tumor in the right lung was indicated by pulmonary CT. Video-associated thoracoscopic surgery lung biopsy showed severe granulomatous inflammation with necrosis in the pulmonary specimen. The case then became complicated to acute renal failure. Renal biopsy specimens revealed pauci-immune type crescentic glomerulonephritis. MPO-ANCA was detected, however, she didn’t have bronchial asthma nor concern with eosinophils in the pathogenesis. The patient was diagnosed as having Wegener’s granulomatosis. Soon the patient was started on a prescription of glucocorticoid and cyclophosphamide. Delirium was seen after 55 days from starting the immunosuppression. Then the patient came to reject all treatments. The patient was introduced to Sapporo Medical University Hospital, and admitted to department of psychiatry on August 2006. The patient was diagnosed as steroid-induced psychosis, and prescribed with a major tranquilizer. Mental symptoms were gradually improved. Surprisingly, pulmonary and renal involvements naturally recovered without additional immunosuppression. Serum MPO-ANCA was declined to normal levels. About 15 months has past since treatments were implemented. No recurrence has occurred to the patient.

収録刊行物

  • 臨床リウマチ

    臨床リウマチ 20 (3), 194-199, 2008

    一般社団法人 日本臨床リウマチ学会

キーワード

詳細情報 詳細情報について

問題の指摘

ページトップへ