Mayo Clinic, Rochester, Minnesota, USA.
Arthritis Care Res (Hoboken). 2011 May;63(5):761-5. doi: 10.1002/acr.20435.
To describe the clinical presentation, laboratory findings, and outcome of patients with Pneumocystis jiroveci pneumonia (PCP) and biopsy-proven giant cell arteritis (GCA) seen at a tertiary referral center.
Using International Classification of Diseases, Ninth Revision codes, all patients with GCA and PCP between January 1, 1976 and December 31, 2008 were identified. Medical records were reviewed. PCP was defined by the identification of Pneumocystis jiroveci organisms in the clinical setting of pneumonia.
We identified 7 patients with GCA (5 women and 2 men) who developed PCP (the mean ± SD age at diagnosis was 71.6 ± 6.1 years). The median time from GCA diagnosis to PCP diagnosis was 3 months (range 1-18 months). All patients were taking prednisone (the median dosage 50 mg/day [range 30-80]) when diagnosed as having PCP. No patients were receiving PCP prophylaxis. PCP was diagnosed by positive smear on bronchoalveolar lavage fluid in 6 patients (86%) and by positive sputum polymerase chain reaction in 1 patient. All the patients were hospitalized (median duration 17 days [range 12-39 days]). Four patients (57%) were admitted to the intensive care unit. Three patients (43%) required mechanical ventilation. Two patients (29%) died; both were on mechanical ventilation.
Although PCP is rare among patients with GCA, this preventable infection is associated with significant morbidity and mortality.
描述在一家三级转诊中心就诊的经活检证实的巨细胞动脉炎（GCA）合并肺囊虫肺炎（PCP）患者的临床表现、实验室检查结果和转归。
使用国际疾病分类，第九版代码，确定 1976 年 1 月 1 日至 2008 年 12 月 31 日期间所有患有 GCA 和 PCP 的患者。回顾病历。PCP 的定义为在肺炎的临床情况下发现卡氏肺孢子虫。
我们共发现 7 例患有 GCA（5 名女性和 2 名男性）并发 PCP（诊断时的平均年龄 ± 标准差为 71.6 ± 6.1 岁）。从 GCA 诊断到 PCP 诊断的中位时间为 3 个月（范围 1-18 个月）。所有患者在诊断为 PCP 时均接受泼尼松治疗（中位剂量 50mg/天[范围 30-80]）。没有患者接受 PCP 预防。6 例（86%）患者通过支气管肺泡灌洗液的阳性涂片诊断为 PCP，1 例患者通过阳性痰聚合酶链反应诊断为 PCP。所有患者均住院（中位住院时间 17 天[范围 12-39 天]）。4 例（57%）患者入住重症监护病房。3 例（43%）患者需要机械通气。2 例（29%）患者死亡；均在接受机械通气。
虽然 PCP 在 GCA 患者中很少见，但这种可预防的感染与显著的发病率和死亡率相关。
