| Autor: |
BERNARD, C., MAUCORT-BOULCH, D., VARRON, L., CHARLIER, C., SITBON, K., FREYMOND, N., BOUHOUR, D., HOT, A., MASQUELET, A. C., VALEYRE, D., COSTEDOAT-CHALUMEAU, N., ETIENNE, M., GUEIT, I., JOUNEAU, S., DELAVAL, P., MOUTHON, L., POUGET, J., SERRATRICE, J., BRION, J.-P., VAYLET, F. |
| Zdroj: |
QJM: An International Journal of Medicine; Jun2013, Vol. 106 Issue 6, p523-539, 17p, 9 Charts |
| Abstrakt: |
Aim: To describe the main characteristics and the treatment of cryptococcosis in patients with sarcoidosis. Design: Multicenter study including all patients notified at the French National Reference Center for Invasive Mycoses and Antifungals. Methods: Retrospective chart review. Each case was compared with two controls without opportunistic infections. Results: Eighteen cases of cryptococcosis complicating sarcoidosis were analyzed (13 men and 5 women). With 2749 cases of cryptococcosis registered in France during the inclusion period of this study, sarcoidosis accounted for 0.6% of all the cryptococcosis patients and for 2.9% of the cryptococcosis HIV-seronegative patients. Cryptococcosis and sarcoidosis were diagnosed concomitantly in four cases; while sarcoidosis was previously known in 14/18 patients, including 12 patients (67%) treated with steroids. The median rate of CD4 T cells was 145 per mm3 (range: 55–1300) and not related to steroid treatment. Thirteen patients had cryptococcal meningitis (72%), three osteoarticular (17%) and four disseminated infections (22%). Sixteen patients (89%) presented a complete response to antifungal therapy. After a mean follow-up of 6 years, no death was attributable to cryptococcosis. Extra-thoracic sarcoidosis and steroids were independent risk factors of cryptococcosis in a logistic regression model adjusted with the sex of the patients. Conclusions: Cryptococcosis is a significant opportunistic infection during extra-thoracic sarcoidosis, which occurs in one-third of the cases in patients without any treatment; it is not associated to severe CD4 lymphocytopenia and has a good prognosis. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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