一個治療紅斑性狼瘡病患併發瀰散性水痘病毒感染的成功經驗

Successful Treatment of Disseminated Varicella Infection in a Case of Systemic Lupus Erythematosus

原發性水痘感染在紅斑性狼瘡的病人常造成瀰散性病毒感染，而且常常是致病的。我們報告一個患有狼瘡的病人得到了原發性的水痘感染，一開始表現是無法局部定位，且進展快速的胸痛及腹痛一天，之後在臉上出現水皰的同時也進展成瀰漫性血管內血凝症及多重器官影響。在接受高劑量免疫球蛋白及抗病毒藥（acyclovir）及積極的輸血支持治療後，病人存活下來。我們認為對患有狼瘡的病人，高度警覺水痘感染以達到早期診斷與早期治療（給予抗病毒藥及免疫球蛋白）是非常重要的。

Primary varicella infection in patients with systemic lupus erythematosus (SLE) usually causes disseminated varicella involvement and is commonly fatal. We report a male patient with lupus who suffered from a primary varicella infection, which presented initially with progressively worsening and poorly localized chest pain, associated with abdominal and back pain for 1 day, followed by vesicular rash which appeared on the patient's face the next days. The patient rapidly compromised to disseminated intravascular coagulopathy and multiple organ involvement. He recovered after high-dose intravenous imnmunoglobulin and acyclovir therapy, and aggressive transfusion treatment. We conclude that it is critical to be alert to primary varicella infection to achieve early diagnosis and treatment with administration of acyclovir and intravenous immunoglobulin in lupus patients with primary varicella infection.