[Cytomegalovirus infection associated with immunosuppressive therapy in collagen vascular diseases].
[Cytomegalovirus infection associated with immunosuppressive therapy in collagen vascular diseases].
复制标题
[胶原血管疾病中与免疫抑制治疗相关的巨细胞病毒感染]。
DOI：
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复制
发表时间：
1999
期刊：
影响因子：
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通讯作者：
R. Masago
中科院分区：
文献类型：
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作者：
S. Yoshihara;N. Fukuma;R. Masago
客观化
采用巨细胞病毒(CMV)抗原血症试验，对胶原血管病免疫抑制治疗过程中巨细胞病毒(CMV)感染的发生率进行了调查。
方法
对15例胶原血管病患者应用强的松龙30 mg/d以上免疫抑制治疗前和治疗后1个月的巨细胞病毒抗原血症进行了分析。
结果
9例(60%)患者检测到CMV抗原血症，治疗前所有患者均未检出CMV抗原血症。9例患者中有7例出现巨细胞病毒感染，如发热、白细胞减少、血小板减少、肝损伤、间质性肺炎。在2例多发性肌炎/皮肌炎患者中，肌酸磷酸激酶(CPK)水平在治疗开始后一度下降，但仍在继续使用强的松龙后再次升高。更昔洛韦治疗后，由于CMV抗原血症阳性，升高的CPK水平立即恢复正常。
结论
我们的结果表明，CMV感染在免疫抑制治疗过程中发生的频率很高，可能与胶原血管疾病的加重相似。在治疗过程中，区分巨细胞病毒感染和胶原血管疾病的活动性是很重要的。
OBJECTIVE
We investigated the frequency of cytomegalovirus (CMV) infection during immunosuppressive therapy in collagen vascular disease by using CMV antigenemia assay.
METHODS
CMV antigenemia in fifteen patients with collagen vascular disease were analyzed before and one month after immunosuppressive therapy with more than 30 mg/day of prednisolone.
RESULTS
CMV antigenemia were detected in 9 patients (60%), however no CMV antigenemia detected in all patients before treatment. In 7 of 9 patients CMV infection occurred such as fever, leucocytopenia, thrombocytopenia, liver injury, interstitial pneumonia. In 2 patients of polymyositis/dermatomyositis, creatine phosphokinase (CPK) levels which had decreased once just after treatment started, elevated again although initial dose of prednisolone continued. After ganciclovir administration because of the positive results of CMV antigenemia, elevated CPK levels were normalized immediately.
CONCLUSION
Our results showed that CMV infection occurred with high frequency during immunosuppressive therapy, and might mimic the exacerbation of collagen vascular disease. It is important to differentiate CMV infection from increased activity of collagen vascular disease during the treatment.