J Rheum Dis.  2014 Aug;21(4):214-218. 10.4078/jrd.2014.21.4.214.

Pulmonary Cryptococcosis in a Patient with Ankylosing Spondylitis treated with Etanercept

Affiliations
  • 1Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
  • 2Division of Rheumatology, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea. kimhaerim@kuh.ac.kr
  • 3Department of Pathology, Konkuk University School of Medicine, Seoul, Korea.

Abstract

Ankylosing spondylitis (AS) is a chronic inflammatory disorder, commonly characterized by inflammation of axial skeleton and development of enthesopathies. Tumor necrosis factor inhibitors (TNFi) shows good therapeutic responses in AS patients without good response to non-steroidal anti-inflammatory drugs. Although TNFi are relatively safe for AS patients, serious opportunistic infections, including tuberculosis and fungal infection, could develop. Here, according to our knowledge, we report a first Korean case of pulmonary cryptococcosis in a patient with AS treated with etanercept. A 64 year-old man with AS visited due to a newly appeared pulmonary nodule on a routine chest radiography. He had been administered etanercept for 5 months. Histologic findings of the lung nodule showed characteristic features of cryptococcosis. Etanercept was discontinued and oral fluconazole was administrated, as there was no evidence of central nervous system involvement. After 7 months of treatment, chest CT showed an improvement of the pulmonary lesion.

Keyword

Ankylosing spondylitis; Pulmonary cryptococcosis; Etanercept; Tumor necrosis factor inhibitor

MeSH Terms

Central Nervous System
Cryptococcosis*
Fluconazole
Humans
Inflammation
Lung
Opportunistic Infections
Radiography
Rheumatic Diseases
Skeleton
Spondylitis, Ankylosing*
Thorax
Tomography, X-Ray Computed
Tuberculosis
Tumor Necrosis Factor-alpha
Etanercept
Fluconazole
Tumor Necrosis Factor-alpha
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