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免疫性疱病及结缔组织病患者接受免疫抑制药物治疗后肺孢子菌肺炎的发生。

Development of Pneumocystis carinii pneumonia in patients with immunobullous and connective tissue disease receiving immunosuppressive medications.

机构信息

Mayo Medical School, College of Medicine, Rochester, Minnesota 55905, USA.

出版信息

J Am Acad Dermatol. 2010 Jun;62(6):957-61. doi: 10.1016/j.jaad.2009.07.042. Epub 2009 Oct 13.

Abstract

BACKGROUND

Pneumocystis carinii pneumonia (PCP) causes morbidity and mortality in immunocompromised hosts. Data describing use of PCP prophylaxis in immunosuppressed dermatologic patients are lacking.

OBJECTIVE

We sought to describe the frequency of PCP among dermatologic patients receiving immunosuppression for immunobullous disease or connective tissue disease.

METHODS

We retrospectively reviewed the cases of patients with immunobullous and connective tissue disease at our department of dermatology between 1980 and 2006 who received immunosuppression and had subsequent development of pneumonia. We recorded patient characteristics, use of PCP prophylaxis, whether PCP developed, and if so, their morbidity and mortality.

RESULTS

Of 334 patients identified, 7 (2.1%) were given the diagnosis of PCP during immunosuppressive treatment. Of these 7 patients, 3 (43%) died within 1 month of diagnosis, and none received PCP prophylaxis.

LIMITATIONS

Retrospective study design and limited patient group are limitations.

CONCLUSIONS

PCP prophylaxis may improve outcomes for some patients with immunobullous or connective tissue disease receiving immunosuppressive therapy.

摘要

背景

卡氏肺孢子虫肺炎(PCP)可导致免疫功能低下宿主的发病率和死亡率。缺乏描述免疫抑制性皮肤科患者中使用卡氏肺孢子虫肺炎预防的资料。

目的

我们旨在描述免疫性大疱性疾病或结缔组织疾病接受免疫抑制治疗的皮肤科患者中卡氏肺孢子虫肺炎的发生频率。

方法

我们回顾性分析了 1980 年至 2006 年期间在我皮肤科就诊的免疫性大疱性疾病和结缔组织疾病患者的病例,这些患者接受了免疫抑制治疗,随后发生了肺炎。我们记录了患者的特征、卡氏肺孢子虫肺炎预防的使用情况、是否发生卡氏肺孢子虫肺炎,以及如果发生,其发病率和死亡率。

结果

在确定的 334 例患者中,有 7 例(2.1%)在免疫抑制治疗期间被诊断为卡氏肺孢子虫肺炎。这 7 例患者中,有 3 例(43%)在诊断后 1 个月内死亡,且均未接受卡氏肺孢子虫肺炎预防。

局限性

回顾性研究设计和有限的患者群体是其局限性。

结论

卡氏肺孢子虫肺炎预防可能改善接受免疫抑制治疗的某些免疫性大疱性疾病或结缔组织疾病患者的结局。

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