Cerebral Toxoplasmosis Diagnosed by Nested-polymerase Chain Reaction in a Patient with Rheumatoid Arthritis

A 65-year-old woman with rheumatoid arthritis (RA) visited our hospital because of right facial sensory hypoesthesia. Cerebral toxoplasmosis was suspected on brain magnetic resonance imaging. We discontinued methotrexate for RA and started a sulfamethoxazole/trimethoprim (ST) mixture. Although ST tr...

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Autores principales: Matsuura, Jun, Fujii, Akihiro, Mizuta, Ikuko, Norose, Kazumi, Mizuno, Toshiki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2018
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995717/
https://www.ncbi.nlm.nih.gov/pubmed/29321415
http://dx.doi.org/10.2169/internalmedicine.0139-17
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author Matsuura, Jun
Fujii, Akihiro
Mizuta, Ikuko
Norose, Kazumi
Mizuno, Toshiki
author_facet Matsuura, Jun
Fujii, Akihiro
Mizuta, Ikuko
Norose, Kazumi
Mizuno, Toshiki
author_sort Matsuura, Jun
collection PubMed
description A 65-year-old woman with rheumatoid arthritis (RA) visited our hospital because of right facial sensory hypoesthesia. Cerebral toxoplasmosis was suspected on brain magnetic resonance imaging. We discontinued methotrexate for RA and started a sulfamethoxazole/trimethoprim (ST) mixture. Although ST treatment was interrupted because of adverse reactions, her prognosis was favorable. The Toxoplasma 18S rDNA gene was detected by nested-polymerase chain reaction (PCR) from blood and cerebrospinal fluid. Detecting the Toxoplasma 18S rDNA gene by nested-PCR is useful for the diagnosis and safer than a brain biopsy. In addition, the discontinuation of immunosuppressants may be recommended in patients compromised by those immunosuppressants.
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spelling pubmed-59957172018-06-13 Cerebral Toxoplasmosis Diagnosed by Nested-polymerase Chain Reaction in a Patient with Rheumatoid Arthritis Matsuura, Jun Fujii, Akihiro Mizuta, Ikuko Norose, Kazumi Mizuno, Toshiki Intern Med Case Report A 65-year-old woman with rheumatoid arthritis (RA) visited our hospital because of right facial sensory hypoesthesia. Cerebral toxoplasmosis was suspected on brain magnetic resonance imaging. We discontinued methotrexate for RA and started a sulfamethoxazole/trimethoprim (ST) mixture. Although ST treatment was interrupted because of adverse reactions, her prognosis was favorable. The Toxoplasma 18S rDNA gene was detected by nested-polymerase chain reaction (PCR) from blood and cerebrospinal fluid. Detecting the Toxoplasma 18S rDNA gene by nested-PCR is useful for the diagnosis and safer than a brain biopsy. In addition, the discontinuation of immunosuppressants may be recommended in patients compromised by those immunosuppressants. The Japanese Society of Internal Medicine 2018-01-11 2018-05-15 /pmc/articles/PMC5995717/ /pubmed/29321415 http://dx.doi.org/10.2169/internalmedicine.0139-17 Text en Copyright © 2018 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Matsuura, Jun
Fujii, Akihiro
Mizuta, Ikuko
Norose, Kazumi
Mizuno, Toshiki
Cerebral Toxoplasmosis Diagnosed by Nested-polymerase Chain Reaction in a Patient with Rheumatoid Arthritis
title Cerebral Toxoplasmosis Diagnosed by Nested-polymerase Chain Reaction in a Patient with Rheumatoid Arthritis
title_full Cerebral Toxoplasmosis Diagnosed by Nested-polymerase Chain Reaction in a Patient with Rheumatoid Arthritis
title_fullStr Cerebral Toxoplasmosis Diagnosed by Nested-polymerase Chain Reaction in a Patient with Rheumatoid Arthritis
title_full_unstemmed Cerebral Toxoplasmosis Diagnosed by Nested-polymerase Chain Reaction in a Patient with Rheumatoid Arthritis
title_short Cerebral Toxoplasmosis Diagnosed by Nested-polymerase Chain Reaction in a Patient with Rheumatoid Arthritis
title_sort cerebral toxoplasmosis diagnosed by nested-polymerase chain reaction in a patient with rheumatoid arthritis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995717/
https://www.ncbi.nlm.nih.gov/pubmed/29321415
http://dx.doi.org/10.2169/internalmedicine.0139-17
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