WANG Miao,ZHU Fenglin,ZHANG Yin,et al.A Case of Rheumatoid Arthritis Complicated With Pneumocystis Pneumonia Treated by Traditional Chinese Medicine[J].,
WANG Miao,ZHU Fenglin,ZHANG Yin,et al.A Case of Rheumatoid Arthritis Complicated With Pneumocystis Pneumonia Treated by Traditional Chinese Medicine[J].,DOI:.
A Case of Rheumatoid Arthritis Complicated With Pneumocystis Pneumonia Treated by Traditional Chinese Medicine
Summary of case history, The patient, a 66-year-old woman, was admitted to the hospital mainly due to "multi-joint swelling and pain for 1 year, with coughing and coughing up a lot of sputum for 10 days". One year ago, the patient was diagnosed with "rheumatoid arthritis" at another hospital due to multiple joint swelling and pain. 3 months ago, she began to take "methotrexate, leflunomide, triptovine" to suppress immunity, and her condition was stable. 10 days ago, the patient caught a cold, with coughing and coughing up a lot of sputum. Past medical history: sulfonamide allergy. Admission symptoms include: cough, cough up a lot of yellow and white sticky sputum, chest tightness, fatigue, lack of desire to eat, dry mouth and bitter mouth, stool is sometimes dry, sometimes loose, pale red tongue, white and greasy, smooth right vein, and chord left vein. Chest CT showed flocculent blur and unclear borders of both lung films. NGS test of alveolar lavage fluid: positive for Pneumocystis carinii.,TCM diagnosis, Syndrome of phlegm-dampness accumulation of lung and Disharmony between liver and spleen.,Western medicine diagnosis, Pneumocystis pneumonia, rheumatoid arthritis, interstitial pneumonia.,Therapeutic methods, Because the patient is allergic to sulfonamides, we cannot use sulfonamide anti-infective therapy. And the patient refuses treatment such as caspofungin. Traditional Chinese medicine has successively given Sanzi Yangqin Decoction, Xiaochai Hu Decoction, and Huangqi Biejia Decoction.,Clinical outcomes, After 4 times of diagnosis and treatment, the patient's symptoms such as cough and sputum production were significantly improved. Repeat chest CT 2 weeks after discharge, the results showed that the flocculent blur in both lungs was not significant.
关键词
卡氏肺孢子菌肺炎类风湿关节炎中药
Keywords
pneumocystis pneumoniarheumatoid arthritistraditional Chinese medicine
references
HSU H C, CHANG Y S, HOU T Y, et al. Pneumocystis jirovecii pneumonia in autoimmune rheumatic diseases: a nationwide population-based study. Clin Rheumatol. 2021;40(9):3755-3763.
TOKUDA H, SAKAI F, YAMADA H, et al. Clinical and radiological features of Pneumocystis pneumonia in patients with rheumatoid arthritis, in comparison with methotrexate pneumonitis and Pneumocystis pneumonia in acquired immunodeficiency syndrome:A multicenter study. Intern Med. 2008;47(10):915-923.
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