<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1870-7203</journal-id>
<journal-title><![CDATA[Acta médica Grupo Ángeles]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. Grupo Ángeles]]></abbrev-journal-title>
<issn>1870-7203</issn>
<publisher>
<publisher-name><![CDATA[Grupo Ángeles, Servicios de Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1870-72032017000300216</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Pneumocystis jirovecii en paciente con artritis reumatoide]]></article-title>
<article-title xml:lang="en"><![CDATA[Pneumocystis jirovecii in rheumatoid arthritis patient]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arellano Aguilar]]></surname>
<given-names><![CDATA[Gregorio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Domínguez Carrillo]]></surname>
<given-names><![CDATA[Luis Gerardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Perales Martínez]]></surname>
<given-names><![CDATA[Diana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez Díaz]]></surname>
<given-names><![CDATA[Juan Luis]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguirre Trigueros]]></surname>
<given-names><![CDATA[José]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Ángeles León División de Medicina ]]></institution>
<addr-line><![CDATA[León Guanajuato]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Guanajuato Facultad de Medicina de León ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Ángeles León División de Medicina ]]></institution>
<addr-line><![CDATA[León Guanajuato]]></addr-line>
<country>México</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Ángeles León División de Medicina ]]></institution>
<addr-line><![CDATA[León Guanajuato]]></addr-line>
<country>México</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Hospital Ángeles León Departamento de Histopatología ]]></institution>
<addr-line><![CDATA[León Guanajuato]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2017</year>
</pub-date>
<volume>15</volume>
<numero>3</numero>
<fpage>216</fpage>
<lpage>220</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1870-72032017000300216&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1870-72032017000300216&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1870-72032017000300216&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Antecedentes:  La neumonía por neumocistosis originada por Pneumocystis jirovecii es una de las enfermedades fúngicas más devastadoras en pacientes con alteraciones de la inmunidad. Las terapias antivirales eficaces han reducido la carga de la PJ en pacientes con SIDA, pero actualmente se reporta incremento en la prevalencia de esta enfermedad entre las personas VIH negativas que reciben tratamientos con inmunosupresores.  Caso clínico:  Paciente femenino de 68 años, diabética, hipertensa controlada, con 15 años de evolución de artritis reumatoide, manejada con esteroides y metotrexate, que ha cursado con múltiples hospitalizaciones en los últimos cuatro meses por neumopatía caracterizada por disnea, tos seca y fiebre, con TAC que muestra neumopatía intersticial criptogénica, con focos de consolidación y fibrosis pulmonar, con biopsia transbronquial y PCR positiva para Pneumocystis jirovecii. Es manejada con trimetoprima-sulfametoxazol y bolos de esteroides, mejorando ostensiblemente en 11 días de hospitalización.  Conclusiones:  El PCR en tiempo real es la herramienta más útil para el diagnóstico de la neumonía por Pneumocystis, por lo que debe efectuarse incluso en pacientes que no tienen síntomas, pero presentan factores de riesgo como cáncer, trastornos hematológicos u otras enfermedades inmunológicas y/o reciben terapia inmunosupresora.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Background: Pneumocystis pneumonia caused by Pneumocystis jirovecii is one of the most devastating fungal diseases in patients with impaired immunity. Effective antiviral therapies have reduced the burden of PJ in patients with AIDS, but increase in the prevalence of this disease among HIV-negative people receiving immunosuppressive treatments currently reported.  Case report:  Female 68, diabetic, hypertensive controlled, with 15 years of evolution of rheumatoid arthritis, managed with steroids and methotrexate, which has completed multiple hospitalizations in the last four months by lung disease characterized by dyspnea, dry cough and fever, TAC showing cryptogenic interstitial lung disease, with foci of consolidation and pulmonary fibrosis, transbronchial biopsy and PCR positive for Pneumocystis jirovecii. Handled with trimethoprim-sulfamethoxazole and steroid boluses, improving significantly in 11 days of hospitalization.  Conclusions:  Real-time PCR is a useful tool for the diagnosis of Pneumocystis pneumonia in non-HIV patients. Hence, a positive Pneumocystis real-time PCR should be taken into account even if the patient does not have symptoms, but has a risk factor like cancer, hematological disorder and/or receives an immunosuppressive therapy.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Pneumocystis jirovecii]]></kwd>
<kwd lng="es"><![CDATA[artritis reumatoide]]></kwd>
<kwd lng="es"><![CDATA[enfermedad pulmonar intersticial]]></kwd>
<kwd lng="en"><![CDATA[Pneumocystis jirovecii]]></kwd>
<kwd lng="en"><![CDATA[interstitial pneumonia]]></kwd>
<kwd lng="en"><![CDATA[rheumatoid arthritis]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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