면역억제 치료를 받는 루푸스신염 환자에서 발생한 일차성 인플루엔자 폐렴 1예

Abstract

많은 루푸스 환자들이 질병 경과 동안 심각한 감염으로 인해 고통 받고 있으며 감염은 루푸스 환자에서 중요한 사망 원인으로 알려져 있다. 면역억제 치료를 받는 루푸스신염 환자처럼 감염의 고위험군인 루푸스 환자에서 폐렴이 의심될 때 치명적일 수 있는 세균감염 및 여러 기회감염을 배제하는 것이 필요하지만, 상대적으로 간과되기 쉬운 인플루엔자 폐렴 또한 염두에 두어야 할 것이다.Infectious diseases, particularly pneumonia, remain a major cause of morbidity and mortality in patients with systemic lupus erythematous (SLE), accounting for 30∼50% of all death. Because infection appears in various forms in lupus patients, early detection and appropriate treatment is very important. In the case of diffuse infiltration in the whole lung field, we should make a differential diagnosis with drug-induced pneumonitis, interstitial lung disease and pneumonia caused by atypical microorganism infection. In particular, in case of atypical microorganism pneumonia, we usually suspect cytomegalovirus, pneumocystis jiroveci and ebstein-barr virus, but influenza pneumonia is relatively neglected. Here, we report on the case of a 26-year-old female patient with lupus nephritis who presented with dyspnea and diffuse pulmonary infiltration immediately after intravenous cyclophosphamide. She was diagnosed with primary influenza B pneumonia and successfully treated with oseltamivir.