[A case of Wegener's granulomatosis complicated with cytomegalovirus pneumonia during the treatment with immunosuppressants].

ABSTRACT

Wegener's granulomatosis was diagnosed in a 60-year-old man on the basis of an increase in serum C-ANCA and of pathological findings obtained by computed tomography-guided lung biopsy. The treatment with prednisolone and cyclophosphamide reduced his symptoms and laboratory data including serum C-ANCA. However, the treatment decreased the peripheral blood lymphocyte count and the patient subsequently complained of a sudden onset of dyspnea. Although chest radiography appeared normal, antigenemia and the polymerase chain reaction for Cytomegalovirus were positive, and also there was an increase in serum antibody titer for Cytomegalovirus. Intravenous administration of Ganciclovir and cessation of cyclophosphamide successfully improved the patient's symptoms. Antigenemia and the polymerase chain reaction for Cytomegalovirus also became negative following the treatment. Thus, it is important to consider the development of opportunistic infections including Cytomegalovirus pneumonia during the treatment of Wegener's granulomatosis with immunosuppressant.