A case of pulmonary cryptococcosis during the use of baricitinib
Keisuke Kanekoa,b Jun Kanazawab Takefumi Saitob Yuko Minamic Shintaro Suzukia Hironori Sagaraa
aDivision of Allergology and Respiratory Medicine, Department of Internal Medicine, Showa University School of Medicine
bInternal Medicine Clinical Department Respiratory Medicine, National Hospital Organization Ibarakihigashi National Hospital, The Center of Chest Diseases and Severe Motor & Intellectual Disabilities
cDepartment of Pathological Diagnosis, National Hospital Organization Ibarakihigashi National Hospital, The Center of Chest Diseases and Severe Motor & Intellectual Disabilities
A 69-year-old man who received baricitinib and salazosulfapyridine for treatment of rheumatoid arthritis developed left-sided chest pain and was admitted to our hospital for further evaluation and treatment. Chest radiography revealed an infiltrative shadow in the left lower lung and chest computed tomography revealed scattered nodular shadows predominantly in the left lower lobe. Serum cryptococcal antigen test results were positive. Evaluation of bronchoscopy specimens showed Cryptococcus neoformans and the patient was diagnosed with pulmonary cryptococcosis. We administered fluconazole, which led to both symptomatic and radiographic improvement. Janus kinase (JAK) inhibitors have increasingly been used as immunosuppressants in recent years; however, few studies have reported cryptococcosis associated with their use. We report a rare case of JAK inhibitor-induced cryptococcosis.
Pulmonary cryptococcosis Baricitinib Janus kinase inhibitor Biological drug Fluconazole (FCZ)
Received 7 Oct 2022 / Accepted 11 Jan 2023
AJRS, 12(2): 88-92, 2023