A fatal case of severe SLE complicated by invasive aspergillosis

Zuber, M; Koch, Babette; Pfreundschuh, M.

doi:10.1007/s002960050021

Cited by 8 publications

(5 citation statements)

References 9 publications

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“…The clinical features of our patient were similar to those reported previously (1,2). She developed aspergillosis while she had active SLE that was being treated with high-dose steroids and cytotoxic agents.…”

Section: Discussionsupporting

confidence: 83%

Invasive Aspergillosis Diagnosed by Fine-Needle Aspiration of the Thyroid Gland

Torres¹,

Agrawal²,

Peters³

et al. 1999

Thyroid

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Invasive aspergillosis has been increasingly recognized as causing significant morbidity and mortality in immunocompromised patients but has never been diagnosed by fine-needle thyroid aspiration. A 24-year-old female with systemic lupus erythematosus presented with cough, shortness of breath, and fever of unknown origin unresponsive to broad-spectrum antibiotics. History and physical examination failed to indicate a source of infection. An mIn white blood cell scan showed thyroid localization. Physical examination revealed a multinodular goiter with a left dominant nodule. Fine-needle aspiration biopsy of a thyroid nodule revealed branching hyphae suggestive of Aspergillus sp. Despite immediate and aggressive treatment with amphotericin B and fluconazole, the patient died of overwhelming infection.Address reprint requests to:

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Section: Discussionsupporting

confidence: 83%

Invasive Aspergillosis Diagnosed by Fine-Needle Aspiration of the Thyroid Gland

Torres¹,

Agrawal²,

Peters³

et al. 1999

Thyroid

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“…Indeed, the risk of infective endocarditis should be discussed as recent invasive dental procedure has been demonstrated as a risk factor for infective endocarditis in SLE patients (Chang, Chang, Chen, Chen, & Chen, 2017). Prophylactic antifungal treatment may also be necessary in some cases because of the increased prevalence of opportunistic fungal infections in SLE patients (Zuber, Daus, Koch, & Pfreundschuh, 1997). Importantly, the use of antifungals should be considered, if possible, prior to the use of anticoagulants due to their potential interactions and subsequent risk of over coagulation as observed with coumarin (Visser et al, 2002).…”

Section: Resultsmentioning

confidence: 99%

Orofacial manifestations and dental management of systemic lupus erythematosus: A review

et al. 2020

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Systemic lupus erythematosus (SLE) is an autoimmune multisystem disease with numerous clinical manifestations. There is no consensus about the ideal oral management for this group of patients to date. This review aimed to describe the broad spectrum of orofacial and clinical manifestations and their therapeutic approaches. Studies concerning orofacial manifestations of SLE and dental treatment modalities were selected by a literature search (1978–2019) using Google Scholar, PubMed/MEDLINE electronic databases. The initial search strategy provided a total of 129 articles, and of these, 30 were included for qualitative synthesis. The reviewed studies revealed that SLE patients are more at risk of compromised oral and dental health exhibiting increased risk of periodontal diseases and temporomandibular joint disorders. The use of systemic drugs especially immunosuppressive and anticoagulants in SLE patients may also influence their oral management. Results emphasize the need to carry out, at an early stage of the disease, an appropriate oral management of these patients to improve oral health‐related quality of life and to prevent the need of more invasive therapeutics. A multidisciplinary approach is needed for dental and medical management of such patients.

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“…There are few reports of invasive aspergillosis in patients with rheumatic diseases, although in a series of 35 cases of invasive aspergillosis, 8.6% of patients had connective tissue disorders (20–24). Identified risk factors include underlying lung disease, prolonged neutropenia, and high‐dose long‐term steroid therapy (20, 22, 23).…”

Section: Discussionmentioning

confidence: 99%