Prognosis of pneumocystis pneumonia complicated in patients with rheumatoid arthritis (RA) and non-RA rheumatic diseases

被引：16

作者：

Yoshida, Yuji ^{[1
]}

Takahashi, Yuko ^{[1
]}

Minemura, Nobuyoshi ^{[1
]}

Ueda, Yo ^{[1
]}

Yamashita, Hiroyuki ^{[1
]}

Kaneko, Hiroshi ^{[1
]}

Mimori, Akio ^{[1
]}

机构：

[1] Natl Ctr Global Hlth & Med, Div Rheumat Dis, Shinjuku Ku, Tokyo 1628655, Japan

来源：

MODERN RHEUMATOLOGY | 2012年 / 22卷 / 04期

关键词：

Pneumocystis pneumonia; Rheumatoid arthritis; Rheumatic diseases; beta-D-glucan; PCR; ACQUIRED-IMMUNODEFICIENCY-SYNDROME; CONNECTIVE-TISSUE DISEASES; CARINII-PNEUMONIA; RADIOLOGICAL FEATURES; JIROVECI PNEUMONIA; DIAGNOSIS; CORTICOSTEROIDS; ASSOCIATION; PREVENTION; INFECTION;

D O I：

10.1007/s10165-011-0523-7

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Clinical presentation of pneumocystis pneumonia (PCP) during immunosuppressive therapy for rheumatic diseases was compared between patients with rheumatoid arthritis (RA; n = 7) and those without RA (non-RA; n = 12) based on a chart review. Both RA and non-RA patients with PCP were treated with methotrexate (n = 7) combined with steroids (n = 6) and/or biologics (n = 4). RA-PCP patients were found to have a higher mortality rate than non-RA-PCP patients (3/7 vs. 0/12, respectively; p = 0.036) due to a later exacerbation of interstitial pneumonia and a higher presentation rate of diffuse pulmonary lesions (4/7 vs. 1/12, respectively; p = 0.036) despite lower mean levels of serum beta-d-glucan (314 +/- A 214 vs. 1139 +/- A 1114 pg/ml, respectively; p = 0.02) that suggested a lower burden of Pneumocystis jirovecii. In conclusion, PCP in RA patients with existing pulmonary lesions may trigger subsequent progression to lethal interstitial pneumonia.

引用

页码：509 / 514

页数：6

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