Successful Treatment of Paecilomyces variotii Pneumonia and Lupus Nephritis With Posaconazole-Cyclophosphamide Co-administration Without Drug Interaction-Induced Toxicity.
Successful Treatment of Paecilomyces variotii Pneumonia and Lupus Nephritis With Posaconazole-Cyclophosphamide Co-administration Without Drug Interaction-Induced Toxicity.
复制标题
泊沙康唑-环磷酰胺联合用药成功治疗变异拟青霉肺炎和狼疮性肾炎，且无药物相互作用引起的毒性。
DOI：
10.1093/ofid/ofad410
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发表时间：
2023
影响因子：
4.2
通讯作者：
Bolaños,Jo
中科院分区：
文献类型：
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作者：
Pechacek,Joseph;Webb,Taura;Ferré,EliseMN;Schmitt,MonicaM;DiMaggio,Thomas;Kobrin,Dale;Rajasimhan,Suraj;Colton,Ben;Lewis,RussellE;Andes,David;Herrera,Alejandro;Hammoud,Dima;Seyedmousavi,Seyedmojtaba;Hasni,Sarfaraz;Bolaños,Jo
变色拟青霉是一种机会性霉菌，它会在免疫抑制的人中引起肺部感染，而这些人通常需要接受三氮唑治疗。狼疮性肾炎是系统性红斑狼疮患者进行性肾病的主要原因，通常需要以环磷酰胺为基础的治疗。三氮唑-环磷酰胺联合给药具有挑战性，因为三氮唑增加了环磷酰胺的浓度，这可能会加剧环磷酰胺的毒性。我们在此描述一位变态拟青霉肺炎并合并狼疮性肾炎的病人，他成功地用泊沙康唑和棘球绦虫桥接中断治疗，以允许环磷酰胺治疗。该方案耐受性良好，无环磷酰胺毒性，在真菌性肺炎和肾功能方面均有改善。
Paecilomyces variotiiis an opportunistic mold that causes pulmonary infections in immunosuppressed humans that are often treated with triazole therapy. Lupus nephritis is a major cause of progressive kidney disease in patients with systemic lupus erythematosus, often requiring cyclophosphamide-based therapies. Triazole-cyclophosphamide co-administration is challenging as triazoles increase cyclophosphamide concentrations, which can worsen cyclophosphamide toxicity. We describe herein a patient withPaecilomyces variotiipneumonia and concomitant lupus nephritis who was successfully treated with posaconazole and echinocandin-bridged interruptions to allow for cyclophosphamide therapy. This regimen was well-tolerated without cyclophosphamide toxicity and achieved improvements in both fungal pneumonia and renal function.